Healthcare Provider Details
I. General information
NPI: 1063382463
Provider Name (Legal Business Name): PREMIER AMBULATORY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/10/2025
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 N MAIN ST
HOPE MILLS NC
28348-1897
US
IV. Provider business mailing address
2047 VALLEYGATE DR
FAYETTEVILLE NC
28304-3688
US
V. Phone/Fax
- Phone: 910-485-3937
- Fax: 910-221-3671
- Phone: 910-221-3670
- Fax: 910-221-3671
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
WOODCOCK
Title or Position: CEO
Credential: MD
Phone: 910-221-3670