Healthcare Provider Details

I. General information

NPI: 1487695284
Provider Name (Legal Business Name): HARFORD COUNTY AMBULATORY SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1952A PULASKI HWY
EDGEWOOD MD
21040-1617
US

IV. Provider business mailing address

9601 PULASKI PARK DR STE 417
MIDDLE RIVER MD
21220-1409
US

V. Phone/Fax

Practice location:
  • Phone: 410-538-7000
  • Fax: 410-679-7825
Mailing address:
  • Phone: 410-933-5678
  • Fax: 410-933-1823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIM MERRILL
Title or Position: NURSE ADMINISTRATOR
Credential: RN BSN
Phone: 410-538-7000