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General NPI Number Information
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NPI Number | 1659899763
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Entity Type | Organization
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Legal Business Name | SHORE HEALTH SYSTEM INC
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1140 BLADES FARM ROAD STE 102
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City | DENTON
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State | MD
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Zip | 21629-3459
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Country | US
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Telephone | 410-479-3510
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Fax | 410-479-3527
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Provider Business Mailing Address
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Address Line | 1140 BLADES FARM RD STE 102
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City | DENTON
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State | MD
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Zip | 21629-3459
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Country | US
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Telephone | 410-479-3510
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Fax | 410-479-3527
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | KENNETH D KOZEL
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Credential |
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Telephone | 410-822-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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