Healthcare Provider Details

I. General information

NPI: 1841281680
Provider Name (Legal Business Name): COMPTROLLER OF MARYLAND CENTRAL PAYROLL BUREAU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5262 WOODS RD
CAMBRIDGE MD
21613-3796
US

IV. Provider business mailing address

5262 WOODS RD
CAMBRIDGE MD
21613-3796
US

V. Phone/Fax

Practice location:
  • Phone: 410-221-2300
  • Fax: 410-221-2534
Mailing address:
  • Phone: 410-221-2300
  • Fax: 410-221-2534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number09-003
License Number StateMD

VIII. Authorized Official

Name: MS. MARY KAY NOREN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LCSW-C
Phone: 410-221-2527