Basic Information
| Provider Information | |||||||||
| NPI: | 1922246206 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNION HOSPITAL OF CECIL COUNTY | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | OPEN MRI AND IMAGING AT PRINCIPIO | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 190 | ||||||||
| Address2: | |||||||||
| City: | ELKTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219220190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103984679 | ||||||||
| FaxNumber: | 4106203686 | ||||||||
| Practice Location | |||||||||
| Address1: | 4863 PULASKI HWY | ||||||||
| Address2: | STE 100 PRINCIPIO HEALTH CENTER | ||||||||
| City: | PERRYVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103984679 | ||||||||
| FaxNumber: | 4106203686 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2009 | ||||||||
| LastUpdateDate: | 01/10/2012 | ||||||||
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| AuthorizedOfficialLastName: | HENRY | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4103984679 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.