Healthcare Provider Details

I. General information

NPI: 1659431781
Provider Name (Legal Business Name): HIGH POINT ENDOSCOPY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 QUAKER LN SUITE C106
HIGH POINT NC
27262-3832
US

IV. Provider business mailing address

624 QUAKER LN SUITE C106
HIGH POINT NC
27262-3832
US

V. Phone/Fax

Practice location:
  • Phone: 336-885-1400
  • Fax: 336-802-2305
Mailing address:
  • Phone: 336-885-1400
  • Fax: 336-802-2305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License NumberAS0059
License Number StateNC

VIII. Authorized Official

Name: MR. LESTER E. HURRELBRINK III
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 336-885-1400