Organization
SUBURBAN HOSPITAL, INC.
Active
Parent organization
SUBURBAN HOSPITAL, INC.
Other names
Suburban Hospital Radiation Oncology Infusion Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUBURBAN HOSPITAL, INC.
Authorized official
MR. BRIAN A. GRAGNOLATI (PRESIDENT)
(301) 896-2574
Entity
Organization
Contact information
Practice address
6420 ROCKLEDGE DR, SUITE 1200, BETHESDA, MD 20817-7837
(301) 896-3901
Mailing address
8600 OLD GEORGETOWN RD, BETHESDA, MD 20814-1422
(301) 896-3901
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
15332
MD
261QI0500X
Infusion Therapy Clinic/Center
15332
MD
261QX0203X
Radiation Oncology Clinic/Center
Primary
15332
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419126900
—
MD
01
—
57352101
BLUE CROSS OF MARYLAND
MD
01
—
715
BLUE CROSS OF NCA
DC
Enumeration date
06/29/2006
Last updated
12/19/2011
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