Organization
GREATER CHESAPEAKE SURGERY CENTER LLC
Active
Other names
Greater Chesapeake Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURI LYNN KELLY R.N. (ADMINISTRATOR)
(410) 821-0009
Entity
Organization
Contact information
Practice address
1212 YORK RD, LUTHERVILLE, MD 21093-6233
(410) 821-0009
(410) 821-0140
Mailing address
1212 YORK ROAD, B101, LUTHERVILLE, MD 21093-6233
(410) 821-0009
(410) 821-0140
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1057
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099Z
MEDICARE ID
MD
05
—
625540000
—
MD
Enumeration date
06/08/2006
Last updated
06/25/2008
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