Healthcare Provider Details

I. General information

NPI: 1356974109
Provider Name (Legal Business Name): GREATER BALTIMORE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 N CHARLES ST STE 3292
BALTIMORE MD
21204-6808
US

IV. Provider business mailing address

6701 N. CHARLES STREET PHARMACY DEPARTMENT
BALTIMORE MD
21204
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-6809
  • Fax: 833-311-0920
Mailing address:
  • Phone: 443-849-6809
  • Fax: 833-311-0920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LAURIE R BEYER
Title or Position: EVP & CFO
Credential:
Phone: 443-849-2519