Provider Demographics
NPI:1215967351
Name:FRIENDSHIP AMBULATORY SURGERY CENTER
Entity type:Organization
Organization Name:FRIENDSHIP AMBULATORY SURGERY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGNIFICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-216-1700
Mailing Address - Street 1:5550 FRIENDSHIP BLVD STE 270
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-7297
Mailing Address - Country:US
Mailing Address - Phone:301-215-7347
Mailing Address - Fax:301-715-7345
Practice Address - Street 1:5550 FRIENDSHIP BLVD STE 270
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7297
Practice Address - Country:US
Practice Address - Phone:301-215-7347
Practice Address - Fax:301-715-7345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1131261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
225660OtherALLIANCE
DC1490OtherBC/BS OF DC
MD225660OtherMDIPA, ALL MAMSI
490002518OtherRAILROAD MEDICARE
MD325991900Medicaid
MDZZ13FROtherBC/BS NASCO ACCTS.
MD225660OtherMAMSI
68-00013OtherEVERCARE
MDZZ13FROtherMARYLAND BC/BS
1143770001OtherPALMETTO GOVT. TRICARE
1490OtherCAREFIRST BLUE CHOICE
MDZZ13FROtherBC/BS NATIONAL ACCTS.
MD225660OtherMDIPA, ALL MAMSI