Organization
COMPTROLLER OF MARYLAND, CENTRAL PAYROLL BUREAU
Active
Other names
Deers Head Hospital Center Renal
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY BETH WAIDE RN, MS, JD (CEO)
(410) 543-4010
Entity
Organization
Contact information
Practice address
351 DEERS HEAD HOSPITAL ROAD, SALISBURY, MD 21801
(410) 543-4132
(410) 543-4140
Mailing address
PO BOX 2964, SALISBURY, MD 21802
(410) 543-4132
(410) 543-4140
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
22001
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
472491700
—
MD
01
—
59022301 02R8 PH8
CAREFIRST BC/BS
MD
Enumeration date
11/04/2005
Last updated
08/09/2012
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