Provider Demographics
NPI:1689748030
Name:BALTIMORE CITY PUBLIC SCHOOL SYSTEM
Entity type:Organization
Organization Name:BALTIMORE CITY PUBLIC SCHOOL SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, TPB TECHNICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:EMILIE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-396-8972
Mailing Address - Street 1:200 E NORTH AVE
Mailing Address - Street 2:THIRD PARTY BILLING, ROOM 201
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-5910
Mailing Address - Country:US
Mailing Address - Phone:410-396-8948
Mailing Address - Fax:410-545-6128
Practice Address - Street 1:200 E NORTH AVE
Practice Address - Street 2:THIRD PARTY BILLING, ROOM 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5910
Practice Address - Country:US
Practice Address - Phone:410-396-8948
Practice Address - Fax:410-545-6128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD541568300Medicaid