CARROLL COUNTY EYE SURGERY CENTER LLC NPI 1255390670

NPI Information

NPI: 1255390670
Provider Name: CARROLL COUNTY EYE SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 21D1021732

Address:
410 MALCOLM DR
SUITE B
WESTMINSTER, MD
ZIP 21157
Phone: (410) 871-3438
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CARROLL COUNTY EYE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Westminster, MD. CARROLL COUNTY EYE SURGERY CENTER, LLC NPI is 1255390670. The provider is registered as an organization entity type.

The provider's business location address is:

410 MALCOLM DR
SUITE B
WESTMINSTER, MD
ZIP 21157-160
Phone: (410) 871-3438
Fax: (410) 871-3428

The provider's authorized official is Angela Robinson .
The authorized official title is Clinical Director and has the following contact phone number (410) 871-3438.

The CLIA number assigned to this NPI record is 21D1021732 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/23/2006 and was last updated on 4/20/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QS0132X	Clinic/Center	Ophthalmologic Surgery	A1394	MARYLAND	No
2	261QA1903X	Clinic/Center	Ambulatory Surgical	A1394	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	64189501	OTHER	MARYLAND	BLUE CROSS BLUE SHIELD MD
2	169Z	MEDICARE ID-TYPE UNSPECIFIED	MARYLAND	MEDICARE NUMBER
3	405915800	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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