Provider Demographics
NPI:1497829642
Name:PAINCARE SURGERY CENTERS III
Entity Type:Organization
Organization Name:PAINCARE SURGERY CENTERS III
Other - Org Name:THE CENTER FOR PAIN MANAGEMENT, ASC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT,CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-377-1073
Mailing Address - Street 1:11921 ROCKVILLE PIKE
Mailing Address - Street 2:STE 505
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2737
Mailing Address - Country:US
Mailing Address - Phone:410-265-7300
Mailing Address - Fax:410-265-9533
Practice Address - Street 1:11921 ROCKVILLE PIKE
Practice Address - Street 2:STE 505
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2737
Practice Address - Country:US
Practice Address - Phone:410-265-7300
Practice Address - Fax:410-265-9533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical