NPIMap

Organization Active NPI

Eastern Avenue Health Solutions Inc.

  • Methadone Clinic
  • Baltimore, MD
National Provider Identifier
1598099061
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
EASTERN AVENUE HEALTH SOLUTIONS INC.
Practice address
5920 Eastern Ave
Baltimore, MD 21224-2730
Phone
(443) 904-3424
Fax
(443) 203-3149
NPI assigned
Sep 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Authorized official

Name
Mr. Moshe Yitzchak Markowitz, LCADC
Title
Clinical Director
Phone
(443) 904-3424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

5920 Eastern Ave
Baltimore, MD 21224-2730

Mailing address

3709 Bancroft Rd
Baltimore, MD 21215-2701
Phone (443) 904-3424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200609002685 MD Part B Supplier - Opioid Treatment Program (Otp) 2163852401 Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Tax ID family
Eastern Avenue Health Solutions Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

125 Slade Ave
Pikesville, MD 21208

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1598099061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 BANCROFT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152701",
            "telephone_number": "443-904-3424",
            "fax_number": "443-203-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242730",
            "telephone_number": "443-904-3424",
            "fax_number": "443-203-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN AVENUE HEALTH SOLUTIONS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "MARKOWITZ",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_middle_name": "YITZCHAK",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "443-904-3424",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCADC"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.