Provider Demographics
NPI:1235434168
Name:AMICARDIAC LLC
Entity type:Organization
Organization Name:AMICARDIAC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GLODEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-232-5100
Mailing Address - Street 1:17810 MEETING HOUSE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANDY SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20860
Mailing Address - Country:US
Mailing Address - Phone:301-232-5100
Mailing Address - Fax:301-232-5105
Practice Address - Street 1:17810 MEETING HOUSE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1038
Practice Address - Country:US
Practice Address - Phone:301-232-5100
Practice Address - Fax:301-232-5105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Single Specialty