1447254172 NPI number — SURGICENTER OF BALTIMORE LLC

Table of content: (NPI 1447254172)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447254172 NPI number — SURGICENTER OF BALTIMORE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SURGICENTER OF BALTIMORE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SURGICENTER OF BALTIMORE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447254172
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 CROSSROADS DR
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
OWINGS MILLS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21117-5420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-356-0300
Provider Business Mailing Address Fax Number:
410-356-7507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 CROSSROADS DRIVE
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
OWINGS MILLS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21117-5476
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-356-0300
Provider Business Practice Location Address Fax Number:
410-356-7507
Provider Enumeration Date:
06/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LAMBIE
Authorized Official First Name:
ROSEMARY
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
DELEGATED OFFICIAL
Authorized Official Telephone Number:
410-356-2409

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  A1045 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NE3 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 242321900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 25872 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 490001255 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 02LM . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 110694 . This is a "KAISER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0181741 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2614116 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 6800095 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 20103019SA . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 055335 . This is a "JOHNS HOPKINS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com