| Organization Name: | WESTERN MARYLAND HEALTH SYSTEM BRADDOCK HOSPITAL CORPORATION |
| NPI Number: | 1639206410 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY S REPAC (SR VP CFO) |
| Mailing Address: | 10701 New Georges Creek Rd Sw Frostburg |
| State: | MD US |
| Postal Code: | 215321457 |
| Phone Number: | 3016893229 |
| Fax Number: | 3017231480 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 07/30/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |