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General NPI Number Information
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NPI Number | 1659698124
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Entity Type | Organization
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Legal Business Name | GRACE MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 2000 W BALTIMORE ST
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City | BALTIMORE
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State | MD
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Zip | 21223-1558
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Country | US
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Telephone | 410-362-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100631
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City | ATLANTA
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State | GA
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Zip | 30384-0631
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Country | US
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Telephone | 410-362-3000
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Fax | 301-631-1002
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Authorized Official
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Title or Position | VP
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Name | REBECCA ALTMAN
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Credential |
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Telephone | 443-924-1856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number | 30-007
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 30-0007
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License Number State | MD
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