Provider Demographics
NPI:1720514359
Name:JOHNS HOPKINS SURGERY CENTERS SERIES
Entity Type:Organization
Organization Name:JOHNS HOPKINS SURGERY CENTERS SERIES
Other - Org Name:KNOLL NORTH SURGERY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISHII
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-583-7185
Mailing Address - Street 1:10803 FALLS ROAD, PAVILLION 3
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20193
Mailing Address - Country:US
Mailing Address - Phone:410-583-7185
Mailing Address - Fax:
Practice Address - Street 1:5450 KNOLL NORTH DR STE 301
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2373
Practice Address - Country:US
Practice Address - Phone:443-546-1750
Practice Address - Fax:443-546-1752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-02
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical