| Ummc Methadone Treatment Program | |
|
1001 W Pratt St Baltimore MD 21223-2679 | |
| (717) 428-0552 | |
| Not Available |
| Full Name | Ummc Methadone Treatment Program |
|---|---|
| Speciality | Clinic/Center |
| Location | 1001 W Pratt St, Baltimore, Maryland |
| Authorized Official Name and Position | George Sprinkel (CFO) |
| Authorized Official Contact | 4103281501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ummc Methadone Treatment Program Po Box 62498 Baltimore MD 21264-2498 Ph: (717) 428-0552 | Ummc Methadone Treatment Program 1001 W Pratt St Baltimore MD 21223-2679 Ph: (717) 428-0552 |
| NPI Number | 1407177447 |
|---|---|
| Provider Enumeration Date | 06/14/2010 |
| Last Update Date | 01/19/2024 |
| Certification Date | 01/19/2024 |
| Medicare PECOS PAC ID | 7113379256 |
|---|---|
| Medicare Enrollment ID | O20240115000221 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407177447 | NPI | - | NPPES |
| 422022600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 100083 (Maryland) | Secondary |
| 261QM2800X | Clinic/center - Methadone | (* (Not Available)) | Primary |
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