Provider Demographics
NPI:1568207223
Name:UNIVERSITY OF MARYLAND MEDICAL REGIONAL PROFESSIONAL SERVICES, LLC
Entity type:Organization
Organization Name:UNIVERSITY OF MARYLAND MEDICAL REGIONAL PROFESSIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP CLINICAL INTEGRATION
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-617-3693
Mailing Address - Street 1:5 BEL AIR SOUTH PKWY STE 1421
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-3812
Mailing Address - Country:US
Mailing Address - Phone:410-569-8587
Mailing Address - Fax:
Practice Address - Street 1:5 BEL AIR SOUTH PKWY STE 1421
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-3812
Practice Address - Country:US
Practice Address - Phone:410-569-8587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies