=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114924453
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARROLL HOSPITAL CENTER, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2005
-----------------------------------------------------
Last Update Date | 09/08/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 292 STONER AVE CARROLL HOSPITAL CENTER
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21157-4847
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-871-8000
-----------------------------------------------------
Fax | 410-871-7216
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 292 STONER AVE CARROLL HOSPITAL CENTER
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21157-4847
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-871-8000
-----------------------------------------------------
Fax | 410-871-7216
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SR. VICE PRESIDENT, FINANCE
-----------------------------------------------------
Name | MICHAEL MYERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 410-848-3000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HH 7144
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------