Provider Demographics
NPI:1487272167
Name:ASCENT SERVICES LLC
Entity type:Organization
Organization Name:ASCENT SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-897-2418
Mailing Address - Street 1:108 OLD SOLOMONS ISLAND RD STE U10
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3848
Mailing Address - Country:US
Mailing Address - Phone:410-573-0888
Mailing Address - Fax:410-949-2168
Practice Address - Street 1:108 OLD SOLOMONS ISLAND RD STE U10
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3848
Practice Address - Country:US
Practice Address - Phone:410-573-0888
Practice Address - Fax:410-949-2168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty