Healthcare Provider Details

I. General information

NPI: 1881488369
Provider Name (Legal Business Name): AMERICAN ACCESS CARE OF NC ASC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4318 MEDICAL PARK DR
DURHAM NC
27704
US

IV. Provider business mailing address

PO BOX 410044
BOSTON MA
02241-0044
US

V. Phone/Fax

Practice location:
  • Phone: 984-243-4520
  • Fax:
Mailing address:
  • Phone: 610-644-8900
  • Fax: 484-924-0053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREGG MILLER
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 717-515-4048