Healthcare Provider Details

I. General information

NPI: 1578424792
Provider Name (Legal Business Name): UPPER CHESAPEAKE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UPPER CHESAPEAKE DR
BEL AIR MD
21014-4324
US

IV. Provider business mailing address

900 ELKRIDGE LANDING ROAD SUITE 2 EAST
LINTHICUM MD
21090-2924
US

V. Phone/Fax

Practice location:
  • Phone: 443-643-1120
  • Fax: 443-643-1301
Mailing address:
  • Phone: 443-643-1120
  • Fax: 443-643-1301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: DONALD JAMES
Title or Position: BUSINESS ANALYST
Credential:
Phone: 240-461-2410