Provider Demographics
NPI:1235117052
Name:ALLEGANY AMBULATORY SURGERY CENTER LLC
Entity Type:Organization
Organization Name:ALLEGANY AMBULATORY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARPEUTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-724-5885
Mailing Address - Street 1:911 SETON DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1817
Mailing Address - Country:US
Mailing Address - Phone:301-724-5885
Mailing Address - Fax:301-759-3332
Practice Address - Street 1:911 SETON DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1817
Practice Address - Country:US
Practice Address - Phone:301-724-5885
Practice Address - Fax:301-759-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1348261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD136ZMedicare UPIN