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PEMBROOKE SQUARE SURGERY CENTER, LLC

Surgery Yellow Pages

Waldorf, Maryland

Provider NPI: 1912993700

Organization Information:
Organization Name:  PEMBROOKE SQUARE SURGERY CENTER, LLC


Practice Location:
11370 PEMBROOKE SQ  WALDORF, MD 20603 US
Tel: 301-396-8492  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QA1903XAmbulatory Health Care Facilities
Clinic/Center
Ambulatory Surgical
MDA1407

Other Provider Identifiers:

IssuerNumberStateType
BCBS NATIONAL CAP AREART6DC01
AETNA HMO377163101
407056900MD05
AETNA PPO786263001
BCBS OF MD64470501MD01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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