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General NPI Number Information
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NPI Number | 1114734506
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Entity Type | Organization
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Legal Business Name | RALEIGH NC ENDOSCOPY ASC LLC
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 2061 RALPH STEPHENS RD
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-8881
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Country | US
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Telephone | 919-791-2060
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Fax |
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Provider Business Mailing Address
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Address Line | 1A BURTON HILLS BLVD STE 300 ATTN: L&C DEPT
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City | NASHVILLE
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State | TN
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Zip | 37215-6153
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Country | US
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Telephone | 919-791-2060
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Fax | 615-234-1720
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | KATHERINE RENEE JUDKINS
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Credential |
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Telephone | 615-240-3770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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