Organization
RANDALLSTOWN CENTER, LLC
Active
Other names
Randallstown Center
Organization subpart
No
Provider details
NPI number
Authorized official
JANE DROPESKEY (CORPORATE MANAGER)
(610) 925-4231
Entity
Organization
Contact information
Practice address
9109 LIBERTY RD, RANDALLSTOWN, MD 21133-3521
(410) 655-7373
(410) 644-0579
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4436
(610) 925-4351
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
03-031
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02YS
CAREFIRST - PROV/INQ#
—
01
—
09004
AMERIGROUP
—
01
—
1077856
AETNA-HMO
—
01
—
340549
UNITED - MAMSI
—
05
—
408132300
—
MD
01
—
71-00181
UNITED - EVERCARE
—
01
—
RY4
CAREFIRST - IND/PPO
—
Enumeration date
06/17/2006
Last updated
08/17/2018
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