Provider Demographics
NPI:1871069799
Name:GILCHRIST HOSPICE CARE, INC.
Entity type:Organization
Organization Name:GILCHRIST HOSPICE CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MODDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-849-8302
Mailing Address - Street 1:6701 N. CHARLES STREET
Mailing Address - Street 2:S. CHAPMAN BUILDING, SUITE 102
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:443-849-6775
Mailing Address - Fax:443-849-3138
Practice Address - Street 1:6701 N CHARLES ST STE 4105
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:443-849-3184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GBMC HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-18
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty