Basic Information
| Provider Information | |||||||||
| NPI: | 1861836330 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PENINSULA REGIONAL MEDICAL CENTER | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | PENINSULA GENERAL HOSPITAL | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E CARROLL ST | ||||||||
| Address2: | PATIENT ACCOUNTS | ||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218015422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105464600 | ||||||||
| FaxNumber: | 4105437020 | ||||||||
| Practice Location | |||||||||
| Address1: | 30265 COMMERCE DR | ||||||||
| Address2: | DELMARVA HEALTH PAVILION | ||||||||
| City: | MILLSBORO | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199663593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105437437 | ||||||||
| FaxNumber: | 4105437020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2013 | ||||||||
| LastUpdateDate: | 04/26/2013 | ||||||||
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| AuthorizedOfficialLastName: | KARNS | ||||||||
| AuthorizedOfficialFirstName: | JEFF | ||||||||
| AuthorizedOfficialMiddleName: | R. | ||||||||
| AuthorizedOfficialTitleorPosition: | EXEC.DIR. PATIENT FINANCIAL SVCS. | ||||||||
| AuthorizedOfficialTelephone: | 4105437437 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | CPAM | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 22-003 | MD | Y | Hospitals | General Acute Care Hospital |
No ID Information.