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Organization
CIVISTA CLINICAL SERVICES, LLC
Active
Organization
CIVISTA CLINICAL SERVICES, LLC
Active
Parent organization
CIVISTA CLINICAL SERVICES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CIVISTA CLINICAL SERVICES, LLC
Authorized official
ALBERT ZANGER (CHIEF FINANCIAL OFFICER)
(301) 609-5163
Entity
Organization
Contact information
Practice address
101 CENTENNIAL ST STE E, LA PLATA, MD 20646-5976
(301) 392-0525
(301) 392-0458
Mailing address
900 ELKRIDGE LANDING RD FL 2, LINTHICUM, MD 21090-2924
(443) 462-5010
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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