Healthcare Provider Details

I. General information

NPI: 1205896446
Provider Name (Legal Business Name): SUBURBAN HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 OLD GEORGETOWN RD
BETHESDA MD
20814-1422
US

IV. Provider business mailing address

8600 OLD GEORGETOWN RD
BETHESDA MD
20814-1422
US

V. Phone/Fax

Practice location:
  • Phone: 301-896-6002
  • Fax:
Mailing address:
  • Phone: 301-896-3901
  • Fax: 301-230-1927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number15332
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number15332
License Number StateMD

VIII. Authorized Official

Name: MS. LEIGHANN SIDONE
Title or Position: PRESIDENT
Credential:
Phone: 301-896-2576