Healthcare Provider Details

I. General information

NPI: 1083970735
Provider Name (Legal Business Name): UNION HOSPITAL OF CECIL COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 SINGERLY AVE
ELKTON MD
21921-5523
US

IV. Provider business mailing address

PO BOX 156
ELKTON MD
21922-0156
US

V. Phone/Fax

Practice location:
  • Phone: 410-392-2686
  • Fax: 410-398-0073
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JUDY RIESEN
Title or Position: CORPORATE DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 410-398-4000