Provider Demographics
NPI:1992895163
Name:RIVERTOWN SURGICENTER P.A.
Entity type:Organization
Organization Name:RIVERTOWN SURGICENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOGE
Authorized Official - Middle Name:HUDSON
Authorized Official - Last Name:DRAKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-567-2100
Mailing Address - Street 1:6188 OXON HILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3113
Mailing Address - Country:US
Mailing Address - Phone:301-567-2100
Mailing Address - Fax:301-567-2399
Practice Address - Street 1:6188 OXON HILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3113
Practice Address - Country:US
Practice Address - Phone:301-567-2100
Practice Address - Fax:301-567-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical