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Organization
ST. AGNES HEALTHCARE, INC.
Active
Organization
ST. AGNES HEALTHCARE, INC.
Active
Parent organization
ST. AGNES HEALTHCARE, INC.
Other names
George Thomas Grace M.D. Surgery Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. AGNES HEALTHCARE, INC.
Authorized official
MR. KEITH VANDER KOLK (PRESIDENT/CEO)
(667) 234-2101
Entity
Organization
Contact information
Practice address
300 FREDERICK RD, SUITE 200, BALTIMORE, MD 21228-4665
(410) 744-0900
(410) 744-3160
Mailing address
3585 WASHINGTON BLVD, HALETHORPE, MD 21227-1676
(667) 234-2149
(667) 234-8644
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1300
MD
Other
Enumeration date
02/09/2009
Last updated
02/25/2016
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