MEDICARE: WESTERN MARYLAND HEALTH SYSTEM CORPORATION

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	251G00000X	Community Based Hospice Care Agency	H1534	MD
2	315D00000X	Inpatient Hospice	H1534	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	:	1952516296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN MARYLAND HEALTH SYSTEM CORPORATION

Provider Business Mailing Address
First Line	:	1050 W INDUSTRIAL BLVD
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-4331
Country	:	US
Telephone Number	:	240-964-9000
Fax Number	:	240-964-8851

Provider Business Practice Location Address
First Line	:	1050 W INDUSTRIAL BLVD
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-4331
Country	:	US
Telephone Number	:	240-964-9000
Fax Number	:	240-964-8851

Authorized Official
Title or Position	:	SR. VP CFO
Name	:	KIMBERLY S REPAC
Credential	:
Telephone Number	:	240-964-7233

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	02/23/2012

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