=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821055393
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UPMC WESTERN MARYLAND CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2006
-----------------------------------------------------
Last Update Date | 10/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12501 WILLOWBROOK RD FL 3
-----------------------------------------------------
City | CUMBERLAND
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21502-2506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-964-9100
-----------------------------------------------------
Fax | 240-964-9101
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12501 WILLOWBROOK RD FL 3
-----------------------------------------------------
City | CUMBERLAND
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21502-2506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-964-9100
-----------------------------------------------------
Fax | 240-964-9101
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SR. VP CFO
-----------------------------------------------------
Name | AMBER R RUBLE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 240-964-8032
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HH7031
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------