Amerigroup Maryland, Inc.
Organization Active NPI Health Maintenance Organization · Hanover, MD
NPI 1992789119 · NPPES record last updated Jul 28, 2009
Key facts
- NPI
- 1992789119
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Maintenance Organization 302R00000X
- License
- 4017 (MD)
- Legal business name
- AMERIGROUP MARYLAND, INC.
- Practice address
- 7550 Teague Rd
Suite 500
Hanover, MD 21076-1339 - Phone
- (410) 859-5800
- Fax
- (410) 981-4010
- NPI assigned
- Dec 1, 2005
- Organization subpart
- No
Authorized official
- Name
- Vincent Michael Ancona
- Title
- President and Ceo
- Phone
- (410) 981-4001
Corporate family (same tax ID) 1
Practitioners 1
-
Virginia Marilyn Moore, M.D.
National Provider Directory
- Tax ID family
- Amerigroup Maryland Inc
Locations
7550 Teague Rd
Ste 500
Hanover, MD 21076
Phone (410) 412-3964
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | 4017 | MD | Yes |
Addresses
Primary practice location
7550 Teague Rd
Suite 500
Hanover, MD 21076-1339
Mailing address
7550 Teague Rd
Suite 500
Hanover, MD 21076-1339
Phone (410) 859-5800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 510300299 | Medicaid | MD |
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All providers in Hanover, MD · Health Maintenance Organization in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.