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NPI Code Detail

MEDICARE: AMBER MEADOWS SURGERY CENTER, LLC.

MEDICARE: AMBER MEADOWS SURGERY CENTER, LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/CenterD0029521MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

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

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Directions to “AMBER MEADOWS SURGERY CENTER, LLC. ” Practice Location

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