Organization
ASC DEVELOPMENT COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J BROUILLETTE DO (REGIONAL MEDICAL DIRECTOR)
(301) 881-7246
Entity
Organization
Contact information
Practice address
11921 ROCKVILLE PIKE, SUITE 505, ROCKVILLE, MD 20852-2737
(301) 881-7246
(301) 881-2449
Mailing address
11350 MCCORMICK RD STE 501, HUNT VALLEY, MD 21031-1002
(301) 881-2449
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00081013
MEDICARE RAILROAD
MD
Enumeration date
03/29/2007
Last updated
04/24/2023
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