=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558270173
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNIVERSITY OF MARYLAND ST. JOSEPH MEDICAL CENTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2026
-----------------------------------------------------
Last Update Date | 09/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7505 OSLER DR STE 212
-----------------------------------------------------
City | TOWSON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21204-7738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-337-4800
-----------------------------------------------------
Fax | 410-337-4517
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 ELKRIDGE LANDING RD STE 2
-----------------------------------------------------
City | LINTHICUM
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21090-2924
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-461-2410
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS ANALYST
-----------------------------------------------------
Name | DONALD JAMES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 240-461-2410
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------