Pembrooke Square Surgery Center, Llc
LBN: Pembrooke Square Surgery Center, Llc
Pembrooke Square Surgery Center, Llc is an health care organization with primary practice located at 11370 Pembrooke Sq , Waldorf MD 20603-4842. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty.
Pembrooke Square Surgery Center, Llc can be contacted via phone (301) 396-8492, or through Conley, Lisa F via phone (301) 396-8492.
Contact Information
Primary practice address
11370 Pembrooke Sq
Waldorf MD 20603-4842
Phone: (301) 396-8492
Fax: (301) 396-8498
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | A1407 | Maryland |
Profile Details
| NPI number | 1912993700 |
|---|---|
| LBN Legal business name | Pembrooke Square Surgery Center, Llc |
| DBA Doing business as | |
| Authorized official | Conley, Lisa F CPC-H |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 27th, 2005 |
| Last updated | Nov 18th, 2009 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912993700 | NPPES |
| Other | 3771631 | AETNA HMO | |
| MEDICAID | 407056900 | AETNA HMO | |
| Other | 64470501 | AETNA HMO | |
| Other | 7862630 | AETNA HMO | |
| Other | RT6 | AETNA HMO |
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