# SURGERY CENTER OF PINEHURST, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003860917
- **Authorized official:** MR. NICK CRANSTON MHA, BSN, RN, CNOR (ADMINISTRATOR)
- **Authorized official phone:** (910) 235-5010

## Contact information

- **Practice address:** 10 FIRST VILLAGE DRIVE, PINEHURST, NC 28374
- **Practice address phone:** (910) 235-5000
- **Practice address fax:** (910) 295-5739
- **Mailing address:** PO BOX 63194, CHARLOTTE, NC 28263-3194
- **Mailing address phone:** (910) 235-5000
- **Mailing address fax:** (910) 295-5739

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 34C0001114 | NC | Yes |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 03/22/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0061T | BLUE CROSS BLUE SHIELD | NC |
| 05 | — | 3409939 | — | NC |
| 01 | — | 611152900 | US DEPT OF LABOR | — |