Provider Demographics
NPI:1235229014
Name:GREENBELT SURGERY CENTER INC
Entity Type:Organization
Organization Name:GREENBELT SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-345-8838
Mailing Address - Street 1:PO BOX 60405
Mailing Address - Street 2:GREENBELT SURGERY CENTER INC
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20859-9407
Mailing Address - Country:US
Mailing Address - Phone:301-469-9333
Mailing Address - Fax:301-469-8223
Practice Address - Street 1:8824 CUNNINGHAM DRIVE
Practice Address - Street 2:GREENBELT SURGERY CENTER INC
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2338
Practice Address - Country:US
Practice Address - Phone:301-345-8834
Practice Address - Fax:301-345-8836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1386261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ASC199Medicare ID - Type Unspecified