Healthcare Provider Details

I. General information

NPI: 1063634467
Provider Name (Legal Business Name): COMPTROLLER OF MARYLAND CENTRAL PAYROLL BUREAU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 DEERS HEAD HOSPITAL RD
SALISBURY MD
21802-2018
US

IV. Provider business mailing address

351 DEERS HEAD HOSPITAL RD PO BOX 2018
SALISBURY MD
21802-2018
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-4000
  • Fax: 410-543-4004
Mailing address:
  • Phone: 410-543-4000
  • Fax: 410-543-4004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD E KEEFER
Title or Position: COO
Credential:
Phone: 410-543-4033