MEDICARE: CLEARWAY SURGERY CENTER OF TIMONIUM 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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1396588141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEARWAY SURGERY CENTER OF TIMONIUM LLC

Provider Business Mailing Address
First Line	:	201 DEFENSE HWY STE 205
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7096
Country	:	US
Telephone Number	:	855-527-7246
Fax Number	:

Provider Business Practice Location Address
First Line	:	2405 YORK RD STE 100
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-2256
Country	:	US
Telephone Number	:	855-527-7246
Fax Number	:	866-229-5063

Authorized Official
Title or Position	:	SR. VICE PRESIDENT
Name	:	BRITNI CULLEN
Credential	:
Telephone Number	:	443-837-9913

Provider Enumeration Date	:	06/18/2024
Last Update Date	:	01/20/2026

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