Organization
UPMC WESTERN MARYLAND CORPORATION
Active
Parent organization
UPMC WESTERN MARYLAND CORPORATION
Other names
UPMC Western Maryland
Organization subpart
Yes
Provider details
NPI number
Legal business name
UPMC WESTERN MARYLAND CORPORATION
Authorized official
AMBER RENEE RUBLE (SR. VP CFO)
(240) 964-8032
Entity
Organization
Contact information
Practice address
12502 WILLOWBROOK RD, SUITE 250, CUMBERLAND, MD 21502-6491
(240) 964-8342
(240) 964-8337
Mailing address
12502 WILLOWBROOK RD, SUITE 250, CUMBERLAND, MD 21502-6491
(240) 964-8342
(240) 964-8337
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
CERTIFICATION #44
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59010001
CAREFIRST BC BS
MD
05
—
759251500
—
MD
01
—
MB4
BLUE CHOICE
DC
Enumeration date
02/16/2007
Last updated
01/25/2022
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