Provider Demographics
NPI:1295969764
Name:CARDIOVASCULAR AMBULATORY SURGERY CENTER OF AMERICA PA
Entity type:Organization
Organization Name:CARDIOVASCULAR AMBULATORY SURGERY CENTER OF AMERICA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ARUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:THAPAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-860-0930
Mailing Address - Street 1:7300 HANOVER DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2202
Mailing Address - Country:US
Mailing Address - Phone:301-860-0930
Mailing Address - Fax:301-809-0929
Practice Address - Street 1:7300 HANOVER DR
Practice Address - Street 2:SUITE 104
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2202
Practice Address - Country:US
Practice Address - Phone:301-860-0930
Practice Address - Fax:301-809-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053733261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD191903OtherMEDICARE PTAN