1740283837 NPI number — WESTERN MARYLAND SURGICENTER LLP

Table of content: (NPI 1740283837)

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".




Copyright © 2007-2024 www.npivalidator.com