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Organization
CARROLL COUNTY EYE SURGERY CENTER, LLC
Active
Organization
CARROLL COUNTY EYE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL PASCETTA (CFO)
(860) 652-5002
Entity
Organization
Contact information
Practice address
410 MALCOLM DR, SUITE B, WESTMINSTER, MD 21157-6160
(410) 871-3438
(410) 871-3428
Mailing address
410 MALCOLM DR STE B, WESTMINSTER, MD 21157-6160
(410) 871-3438
(410) 871-3429
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1394
MD
261QS0132X
Ophthalmologic Surgery Clinic/Center
A1394
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405915800
—
MD
01
—
64189501
BLUE CROSS BLUE SHIELD MD
MD
Enumeration date
03/23/2006
Last updated
07/09/2026
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