MEDICARE: EASTER SEALS DELAWARE & MARYLAND'S EASTERN SHORE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385HR2050X	Respite Care Camp		MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457736308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTER SEALS DELAWARE & MARYLAND'S EASTERN SHORE

Provider Business Mailing Address
First Line	:	22242 BAY SHORE RD
Second Line	:
City	:	CHESTERTOWN
State	:	MD
Zip	:	21620-4407
Country	:	US
Telephone Number	:	410-778-0566
Fax Number	:

Provider Business Practice Location Address
First Line	:	22242 BAY SHORE RD
Second Line	:
City	:	CHESTERTOWN
State	:	MD
Zip	:	21620-4407
Country	:	US
Telephone Number	:	410-778-0566
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT - FINANCE
Name	:	JOHN P MILLER
Credential	:
Telephone Number	:	302-221-2034

Provider Enumeration Date	:	07/21/2015
Last Update Date	:	07/21/2015

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Directions to “EASTER SEALS DELAWARE & MARYLAND'S EASTERN SHORE ” Practice Location

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