Provider Demographics
NPI:1588333959
Name:HARFORD COUNTY AMBULATORY SURGICAL CENTER
Entity type:Organization
Organization Name:HARFORD COUNTY AMBULATORY SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSB
Authorized Official - Phone:410-538-7000
Mailing Address - Street 1:1952 PULASKI HWY # A
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-1658
Mailing Address - Country:US
Mailing Address - Phone:410-538-7000
Mailing Address - Fax:410-679-4291
Practice Address - Street 1:1952 PULASKI HWY # A
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1658
Practice Address - Country:US
Practice Address - Phone:410-538-7000
Practice Address - Fax:410-679-4291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty