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General NPI Number Information
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NPI Number | 1205897691
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Entity Type | Organization
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Legal Business Name | REISTERSTOWN AMBULATORY SURGICAL CENTER
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 113 WESTMINSTER RD SUITE 104
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1026
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Country | US
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Telephone | 410-526-4401
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Fax | 410-526-4414
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Provider Business Mailing Address
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Address Line | 113 WESTMINSTER RD SUITE 104
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1026
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Country | US
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Telephone | 410-526-4401
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Fax | 410-526-4414
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | BARBARA A MATTHEWS
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Credential |
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Telephone | 410-526-4402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | A1335
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License Number State | MD
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