Organization
CARESOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY ULAND (RESOURCE)
(410) 391-2627
Entity
Organization
Contact information
Practice address
9114 PHILADELPHIA RD, BALTIMORE, MD 21237-4345
(410) 391-2627
(443) 320-0285
Mailing address
9114 PHILADELPHIA RD, BALTIMORE, MD 21237-4345
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
R079776
MD
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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