Provider Demographics
NPI:1467563387
Name:AMI CARDIAC MONITORING LLC
Entity Type:Organization
Organization Name:AMI CARDIAC MONITORING LLC
Other - Org Name:AMI CARDIAC MONITORING, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GLODEK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-232-5100
Mailing Address - Street 1:1803 RESEARCH BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3175
Mailing Address - Country:US
Mailing Address - Phone:301-232-5100
Mailing Address - Fax:301-323-5105
Practice Address - Street 1:1803 RESEARCH BLVD STE 600
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3175
Practice Address - Country:US
Practice Address - Phone:301-232-5100
Practice Address - Fax:301-323-5105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD246XC2901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XC2901XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularCardiovascular Invasive SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD414475900Medicaid