1740283837 NPI number — WESTERN MARYLAND SURGICENTER LLP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740283837 NPI number — WESTERN MARYLAND SURGICENTER LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTERN MARYLAND SURGICENTER LLP
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:
Provider Other Organization Name Type Code:
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:
1740283837
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
925 BISHOP WALSH RD
Provider Second Line Business Mailing Address:
STE 2
Provider Business Mailing Address City Name:
CUMBERLAND
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21502-1845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-722-0708
Provider Business Mailing Address Fax Number:
301-777-3135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
925 BISHOP WALSH RD
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
CUMBERLAND
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21502-1845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-722-0708
Provider Business Practice Location Address Fax Number:
301-777-3135
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
STRAUSS
Authorized Official First Name:
HOWARD
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-777-8227

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  A1198 , 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: 21C-0001198 . This is a "CMS (HCFA)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 583732 . This is a "RENDERING BC/BS CARE 1ST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: PT 9-7-1-02 . This is a "BLUE CHOICE (GHMSI)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 021CWE . This is a "CAREFIRST GROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 331-331-000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 241851 . This is a "MAMSI/MDIPA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 490002966 . This is a "MEDICARE GBA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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