Healthcare Provider Details

I. General information

NPI: 1093960395
Provider Name (Legal Business Name): GRAYSTONE EYE SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 CENTURY PL SE
HICKORY NC
28602-4031
US

IV. Provider business mailing address

PO BOX 3528
HICKORY NC
28603-3528
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-2050
  • Fax: 828-345-0522
Mailing address:
  • Phone: 828-322-2050
  • Fax: 828-345-0522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberAS0036
License Number StateNC

VIII. Authorized Official

Name: SHERRY B CALHOUN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 828-322-2050