Provider Demographics
NPI:1033141825
Name:GREENSPRING SURGERY CENTER LLC
Entity Type:Organization
Organization Name:GREENSPRING SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-653-0077
Mailing Address - Street 1:2700 QUARRY LAKE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3742
Mailing Address - Country:US
Mailing Address - Phone:410-653-0077
Mailing Address - Fax:410-653-0463
Practice Address - Street 1:2700 QUARRY LAKES DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209
Practice Address - Country:US
Practice Address - Phone:410-653-0077
Practice Address - Fax:410-653-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD304891800Medicaid
MDV014Medicare ID - Type Unspecified
MDC57445Medicare UPIN