Healthcare Provider Details

I. General information

NPI: 1841347143
Provider Name (Legal Business Name): RUXTON SURGICENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8322 BELLONA AVE SUITE 201
TOWSON MD
21204-2012
US

IV. Provider business mailing address

8322 BELLONA AVE SUITE 201
TOWSON MD
21204-2012
US

V. Phone/Fax

Practice location:
  • Phone: 410-337-2688
  • Fax: 410-337-2606
Mailing address:
  • Phone: 410-337-2688
  • Fax: 410-337-2606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CINDI BITTNER
Title or Position: SURGICENTER DIRECTOR
Credential: RN,CNOR
Phone: 410-337-2688