Organization
CARROLL COUNTY EYE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA ROBINSON (CLINICAL DIRECTOR)
(410) 871-3438
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, SUITE B, WESTMINSTER, MD 21157-6160
(410) 871-3438
(410) 871-3428
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
04/20/2016
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