ANTIETAM UROSURGICAL CENTER LLC ASC; NPI #1437106846

Contact Information

ANTIETAM UROSURGICAL CENTER LLC ASC

11110 MEDICAL CAMPUS RD
SUITE 228
HAGERSTOWN, MD 21742-6700

Phone: 301-733-0022
Fax: 301-733-3461
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for ANTIETAM UROSURGICAL CENTER LLC ASC

NPI Number 1437106846

LBN Legal business name ANTIETAM UROSURGICAL CENTER LLC ASC

Authorized official DEBBIE KLAUKA - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/30/2006

Last updated 03/22/2016 - About 10 years ago

Identifiers

MD	License #	A1224
	Other	21C0001224	CCN

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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