Organization
CIVISTA CLINICAL SERVICES, LLC
Active
Parent organization
CIVISTA CLINICAL SERVICES, LLC
Other names
UM Charles Regional Endoscopy Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CIVISTA CLINICAL SERVICES, LLC
Authorized official
ALBERT ZANGER (CHIEF FINANCIAL OFFICER)
(301) 609-5163
Entity
Organization
Contact information
Practice address
5 N LA PLATA CT STE 201, LA PLATA, MD 20646-5208
(301) 609-4000
Mailing address
5 N LA PLATA CT STE 201, LA PLATA, MD 20646-5208
(301) 609-5080
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2019
Last updated
03/02/2020
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