Organization
JOHNS HOPKINS EMERGENCY MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHANTELL MARIE HAINES (SUPERVISOR)
(240) 529-1456
Entity
Organization
Contact information
Practice address
5755 CEDAR LN, COLUMBIA, MD 21044-2912
(240) 529-1456
Mailing address
PO BOX 418937, BOSTON, MA 02241-8937
(240) 529-1456
(301) 631-5589
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022004300
—
MD
01
—
CH7643
RAILROAD MEDICARE
MD
01
—
F754
BCBS FEDERAL
MD
01
—
LV01
BCBS
MD
Enumeration date
10/26/2005
Last updated
10/22/2013
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