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NPI Code Detail

MEDICARE: SHEPPARD PRATT HEALTH SYSTEM, INC.

MEDICARE: SHEPPARD PRATT HEALTH SYSTEM, INC.
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
1261QM0855XAdolescent and Children Mental Health Clinic/Center3794MD

Other Identifiers

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

General Provider Information

NPI Number : 1841344470
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHEPPARD PRATT HEALTH SYSTEM, INC.
Provider Business Mailing Address
First Line : 6501 N CHARLES ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21204-6819
Country : US
Telephone Number : 410-938-3150
Fax Number : 410-938-3159
Provider Business Practice Location Address
First Line : 10100 COUNTRY CLUB RD SE
Second Line :
City : CUMBERLAND
State : MD
Zip : 21502-8339
Country : US
Telephone Number : 410-777-2258
Fax Number : 301-777-2364
Authorized Official
Title or Position : VP CORPORATE BUSINESS DEVELOPMENT
Name : MS. BONNIE B. KATZ
Credential :
Telephone Number : 410-938-3150
Provider Enumeration Date : 01/22/2007
Last Update Date : 11/22/2021

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Directions to “SHEPPARD PRATT HEALTH SYSTEM, INC. ” Practice Location

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