Healthcare Provider Details

I. General information

NPI: 1518208883
Provider Name (Legal Business Name): ASC DEVELOPMENT COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2013
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19735 GERMANTOWN RD SUITE 360
GERMANTOWN MD
20874-1214
US

IV. Provider business mailing address

PO BOX 931606
ATLANTA GA
31193-1606
US

V. Phone/Fax

Practice location:
  • Phone: 301-528-2811
  • Fax: 301-528-2819
Mailing address:
  • Phone:
  • Fax:

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: SHANEKA TINCH
Title or Position: RCM MANAGER
Credential:
Phone: 469-458-9222