Provider Demographics
NPI:1558876367
Name:PARK CENTER SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:PARK CENTER SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RISHI
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATNAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-498-0383
Mailing Address - Street 1:14201 PARK CENTER DR STE 408
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5251
Mailing Address - Country:US
Mailing Address - Phone:301-498-0383
Mailing Address - Fax:240-712-5052
Practice Address - Street 1:14201 PARK CENTER DR STE 408
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5251
Practice Address - Country:US
Practice Address - Phone:301-498-0383
Practice Address - Fax:240-712-5052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical