RIVER ROAD SURGERY CENTER NPI 1023169752

NPI Information

NPI: 1023169752
Provider Name: RIVER ROAD SURGERY CENTER
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 21D2004679

Address:
5110 RIDGEFIELD ROAD
SUITE 106
BETHESDA, MD
ZIP 20816
Phone: (301) 652-7130
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RIVER ROAD SURGERY CENTER is an ambulatory surgical clinic center in Bethesda, MD. RIVER ROAD SURGERY CENTER NPI is 1023169752. The provider is registered as an organization entity type.

The provider's business location address is:

5110 RIDGEFIELD ROAD
SUITE 106
BETHESDA, MD
ZIP 20816
Phone: (301) 652-7130
Fax: (301) 652-3170

The provider's authorized official is Beverly Lighty .
The authorized official title is Administrator and has the following contact phone number (301) 652-7130.

The CLIA number assigned to this NPI record is 21D2004679 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 8/20/2008.

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	261QA1903X	Clinic/Center	Ambulatory Surgical	A1337	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	300902500	MEDICAID	MARYLAND
2	A00029	MEDICARE PIN

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: 11/14/2023

NPI Synchronization or Removal

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