Provider Demographics
NPI:1871609545
Name:COMPTROLLER OF MARYLAND CENTRAL PAYROLL BUREAU
Entity type:Organization
Organization Name:COMPTROLLER OF MARYLAND CENTRAL PAYROLL BUREAU
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, IWB
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-704-3097
Mailing Address - Street 1:TOWSON UNIVERSITY SPEECH-HEARING CLINIC
Mailing Address - Street 2:8000 YORK ROAD
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21252-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8000 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21252-0001
Practice Address - Country:US
Practice Address - Phone:410-704-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPTROLLER OF MARYLAND CENTRAL PAYROLL BUREAU
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-22
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00173231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD988348700Medicaid
MDN199OtherFEDERAL BLUE CROSS