=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285042424
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANKLIN SQUARE HOSPITAL CENTER, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2014
-----------------------------------------------------
Last Update Date | 07/31/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9110 PHILADELPHIA RD SUITE 200
-----------------------------------------------------
City | ROSEDALE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21237-4301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-554-2855
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9110 PHILADELPHIA RD SUITE 200
-----------------------------------------------------
City | ROSEDALE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21237-4301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-554-2855
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR REVENUE CYCLE
-----------------------------------------------------
Name | LISA SHARKEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 443-777-7142
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | H450
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------