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Organization
SNOWDEN RIVER SURGERY CENTER LLC
Active
Organization
SNOWDEN RIVER SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY C GROCHMAL M.D. (MEDICAL DIRECTOR)
(410) 461-0960
Entity
Organization
Contact information
Practice address
6011 UNIVERSITY BLVD, SUITE 190, ELLICOTT CITY, MD 21043-6074
(410) 461-0960
(410) 461-0967
Mailing address
6011 UNIVERSITY BLVD, SUITE 190, ELLICOTT CITY, MD 21043-6074
(410) 461-0960
(410) 461-0967
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1416
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116594
JOHN HOPKINS HEALTH CARE
MD
01
—
2139172
UNITED HEALTH CARE MAMSI
MD
01
—
253605
KAISER PERMANENTE
MD
01
—
3968840
AETNA MEDICARE
MD
01
—
408126900
MEDICAL ASSISTANCE
MD
01
—
64628701
CARE FIRST BCBS
MD
01
—
7374667
AETNA PPO
MD
01
—
P00220115
RAILROAD MEDICARE
MD
01
—
RW3
CARE FIRST BCBS XIC
MD
Enumeration date
07/12/2005
Last updated
01/06/2015
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