MEDICARE: SIMCARE ASC 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	:	1538427943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMCARE ASC LLC

Provider Business Mailing Address
First Line	:	1021 MAIN ST
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20878-5586
Country	:	US
Telephone Number	:	732-309-5384
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 BACK ACRE CIR
Second Line	:	SUITE 290A
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-7769
Country	:	US
Telephone Number	:	732-309-5384
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. AUDHIR RAO
Credential	:	MD
Telephone Number	:	732-309-5384

Provider Enumeration Date	:	04/24/2012
Last Update Date	:	04/24/2012

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