Healthcare Provider Details

I. General information

NPI: 1306887716
Provider Name (Legal Business Name): MERIDIAN HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 YORK RD
TOWSON MD
21204-7513
US

IV. Provider business mailing address

101 E STATE ST
KENNETT SQUARE PA
19348-3109
US

V. Phone/Fax

Practice location:
  • Phone: 410-821-5500
  • Fax: 410-821-6735
Mailing address:
  • Phone: 610-925-4436
  • Fax: 610-925-4351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number03-048
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier02AB
Identifier TypeOTHER
Identifier State
Identifier IssuerCAREFIRST PROV/INQ#
# 2
Identifier08969
Identifier TypeOTHER
Identifier State
Identifier IssuerAMERIGROUP
# 3
Identifier0181364
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA-NONHMO
# 4
Identifier033657200
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer

VIII. Authorized Official

Name: JANE DROPESKEY
Title or Position: CORPORATE MANAGER
Credential:
Phone: 610-925-4231