MEDICARE: HAMILTON CENTER, LLC

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	314000000X	Skilled Nursing Facility	30-025	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	02YC	OTHER	CAREFIRST-PROV/INQ#
2	08902	OTHER	AMERIGROUP
3	445105	OTHER	UNITED - MAMSI
4	71-00170	OTHER	UNITED - EVERCARE
5	RY1	OTHER	CAREFIRST BLUECHOICE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	RY1	OTHER	CAREFIRST-IND/PPO
8	1076980	OTHER	AETNA-HMO

General Provider Information

NPI Number	:	1558318774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMILTON CENTER, LLC

Provider Business Mailing Address
First Line	:	101 E STATE ST
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-3109
Country	:	US
Telephone Number	:	610-925-4436
Fax Number	:	610-925-4351

Provider Business Practice Location Address
First Line	:	6040 HARFORD RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21214-1327
Country	:	US
Telephone Number	:	410-426-8855
Fax Number	:	410-444-1260

Authorized Official
Title or Position	:	CORPORATE MANAGER
Name	:	JANE DORPESKEY
Credential	:
Telephone Number	:	610-925-4231

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	06/21/2018

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Directions to “HAMILTON CENTER, LLC ” Practice Location

Language	Start Address	Practice Location

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