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General NPI Number Information
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NPI Number | 1750663076
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Entity Type | Organization
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Legal Business Name | UM SHORE REGIONAL HEALTH, INC
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 100 BROWN ST
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City | CHESTERTOWN
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State | MD
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Zip | 21620-1435
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Country | US
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Telephone | 410-778-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 100 BROWN ST
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City | CHESTERTOWN
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State | MD
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Zip | 21620-1435
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Country | US
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Telephone | 410-778-3300
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 21D0220377
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License Number State | MD
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