Provider Demographics
NPI:1184106049
Name:SURGCENTER OF NORTHERN BALTIMORE, LLC
Entity type:Organization
Organization Name:SURGCENTER OF NORTHERN BALTIMORE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PIGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-657-8008
Mailing Address - Street 1:7 GARRISON FARMS CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1847
Mailing Address - Country:US
Mailing Address - Phone:410-657-8008
Mailing Address - Fax:410-657-8006
Practice Address - Street 1:215 SCHILLING CIR STE 110-112
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-1108
Practice Address - Country:US
Practice Address - Phone:410-657-8008
Practice Address - Fax:410-657-8006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical