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General NPI Number Information
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NPI Number | 1407632847
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Entity Type | Organization
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Legal Business Name | TIMONIUM ENDOSCOPY CENTER LLC
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Dates
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Enumeration Date | 09/01/2023
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 1212 YORK RD STE B101
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City | LUTHERVILLE
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State | MD
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Zip | 21093-6233
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Country | US
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Telephone | 410-290-6677
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Fax | 410-290-6676
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Provider Business Mailing Address
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Address Line | 7120 MINSTREL WAY STE 100
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City | COLUMBIA
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State | MD
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Zip | 21045-5274
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Country | US
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Telephone | 410-290-6677
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Fax | 410-290-6676
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Authorized Official
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Title or Position | CEO
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Name | ZACHARY JONES
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Credential |
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Telephone | 207-631-7837
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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 |
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License Number State |
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