Provider Demographics
NPI:1871761007
Name:SUBURBAN HOSPITAL, INC.
Entity type:Organization
Organization Name:SUBURBAN HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PFS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:O'BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-896-6002
Mailing Address - Street 1:PO BOX 79049
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0049
Mailing Address - Country:US
Mailing Address - Phone:412-826-1065
Mailing Address - Fax:412-826-1491
Practice Address - Street 1:8600 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1422
Practice Address - Country:US
Practice Address - Phone:301-896-6508
Practice Address - Fax:301-896-6505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUBURBAN HOSPITAL HEALTH SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG02370Medicare PIN