Healthcare Provider Details

I. General information

NPI: 1508656711
Provider Name (Legal Business Name): GREATER BALTIMORE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10085 RED RUN BLVD STE 207
OWINGS MILLS MD
21117-4836
US

IV. Provider business mailing address

6701 N CHARLES ST SOUTH CHAPMAN BLDG, STE 102
BALTIMORE MD
21204
US

V. Phone/Fax

Practice location:
  • Phone: 410-363-7123
  • Fax: 410-363-0054
Mailing address:
  • Phone: 443-849-2435
  • Fax: 443-849-3138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA CAMPBELL
Title or Position: INTERIM EVP/CFO
Credential:
Phone: 443-849-3844