Provider Demographics
NPI:1063459451
Name:CARROLL COUNTY AMBULATORY SURGICAL CENTER
Entity Type:Organization
Organization Name:CARROLL COUNTY AMBULATORY SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-848-2203
Mailing Address - Street 1:826 WASHINGTON ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:410-848-2203
Mailing Address - Fax:410-848-2283
Practice Address - Street 1:826 WASHINGTON ROAD
Practice Address - Street 2:SUITE 220
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-848-2203
Practice Address - Fax:410-848-2283
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARROLL COUNTY AMBULATORY SURGICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018903261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0018903Medicare UPIN
MD091ZMedicare ID - Type Unspecified