Provider Demographics
NPI:1023103710
Name:UNION HOSPITAL OF CECIL COUNTY
Entity type:Organization
Organization Name:UNION HOSPITAL OF CECIL COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:GERACIMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-392-7008
Mailing Address - Street 1:101 COLONIAL WAY
Mailing Address - Street 2:
Mailing Address - City:RISING SUN
Mailing Address - State:MD
Mailing Address - Zip Code:21911-2283
Mailing Address - Country:US
Mailing Address - Phone:410-398-4000
Mailing Address - Fax:410-620-1493
Practice Address - Street 1:101 COLONIAL WAY
Practice Address - Street 2:
Practice Address - City:RISING SUN
Practice Address - State:MD
Practice Address - Zip Code:21911-2283
Practice Address - Country:US
Practice Address - Phone:410-398-4000
Practice Address - Fax:410-620-1493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07005282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE520607RADOtherBC DELAWARE OFF SITE RADS
MDDD771RUOtherBC MD
DE520607LABOtherBC DEL OFF SITE LABS
MD407431900Medicaid
DE520607LABOtherBC DEL OFF SITE LABS