Provider Demographics
NPI:1841939535
Name:ADVANCED AMBULATORY SURGERY CENTER LLC
Entity type:Organization
Organization Name:ADVANCED AMBULATORY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MANU
Authorized Official - Middle Name:
Authorized Official - Last Name:SIKKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-812-5968
Mailing Address - Street 1:8714 HICKORY BEND TRL
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2557
Mailing Address - Country:US
Mailing Address - Phone:844-319-7758
Mailing Address - Fax:301-652-1274
Practice Address - Street 1:5530 WISCONSIN AVE STE 1201
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4301
Practice Address - Country:US
Practice Address - Phone:301-652-1231
Practice Address - Fax:301-652-1274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical