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General NPI Number Information
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NPI Number | 1306924170
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Entity Type | Organization
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Legal Business Name | DELMAR SURGICAL CENTER LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 103 CHESAPEAKE BLVD STE C
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City | ELKTON
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State | MD
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Zip | 21921-6313
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Country | US
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Telephone | 410-392-6133
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Fax | 410-392-4958
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Provider Business Mailing Address
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Address Line | 103 CHESAPEAKE BLVD STE C
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City | ELKTON
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State | MD
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Zip | 21921-6313
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Country | US
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Telephone | 410-392-6133
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Fax | 410-392-4958
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | JACQUELINE J STACK
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Credential |
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Telephone | 774-320-3040
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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 | D0036586
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License Number State | MD
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