NPIMap

Organization Active NPI

Comptroller of Maryland, Central Payroll Bureau

Doing business as Western Maryland Hospital Center Renal

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hagerstown, MD
National Provider Identifier
1174514996
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
21013 Issued in MD
Legal business name
COMPTROLLER OF MARYLAND, CENTRAL PAYROLL BUREAU
Doing business as
Western Maryland Hospital Center Renal
Practice address
1500 Pennsylvania Ave
Hagerstown, MD 21742-3112
Phone
(301) 745-3748
Fax
(301) 745-3598
NPI assigned
Nov 1, 2005
Last updated
Aug 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Cynthia M Pellegrino, BSN MED
Title
Chief Executive Officer
Phone
(301) 791-4410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 21013 MD Primary

Addresses

Primary practice location

1500 Pennsylvania Ave
Hagerstown, MD 21742-3112

Mailing address

PO Box 2964
Salisbury, MD 21802-2964
Phone (410) 543-4132

Other identifiers 3

IdentifierTypeStateIssuer
472501800MedicaidMD
02R7OtherMDCAREFIRST BCBS PLANS
PH7OtherMDCAREFIRST BCBS PLANS

Other names 1

  • Western Maryland Hospital Center Renal Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1174514996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2964",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218022964",
            "telephone_number": "410-543-4132",
            "fax_number": "410-543-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PENNSYLVANIA AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217423112",
            "telephone_number": "301-745-3748",
            "fax_number": "301-745-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPTROLLER OF MARYLAND, CENTRAL PAYROLL BUREAU",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "PELLEGRINO",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "301-791-4410",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN MED"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MD",
            "license": "21013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "472501800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS PLANS",
            "identifier": "02R7",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS PLANS",
            "identifier": "PH7",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Maryland Hospital Center Renal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.