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General NPI Number Information
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NPI Number | 1265709778
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Entity Type | Organization
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Legal Business Name | AMBER MEADOWS SURGERY CENTER, LLC.
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 186 THOMAS JOHNSON DR SUITE 104
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City | FREDERICK
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State | MD
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Zip | 21702-4305
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Country | US
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Telephone | 301-695-6466
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Fax | 301-695-1094
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Provider Business Mailing Address
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Address Line | 186 THOMAS JOHNSON DR SUITE 104
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City | FREDERICK
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State | MD
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Zip | 21702-4305
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Country | US
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Telephone | 301-695-6466
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Fax | 301-695-1094
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SAMANTHA BEALL
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Credential | RN
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Telephone | 301-695-6466
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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 | D0029521
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License Number State | MD
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