# SURGICAL CENTER OF GREENSBORO LLC

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

## Provider details

- **NPI number:** 1033660451
- **Authorized official:** JENNIFER GRAHAM (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (336) 272-0012

## Contact information

- **Practice address:** 705 GREEN VALLEY RD, GREENSBORO, NC 27408-7019
- **Practice address phone:** (336) 272-0012
- **Practice address fax:** (336) 544-2150
- **Mailing address:** 705 GREEN VALLEY RD, GREENSBORO, NC 27408-7019
- **Mailing address phone:** (336) 272-0012
- **Mailing address fax:** (336) 544-2150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | AS0018 | NC | Yes |

## Other

- **Enumeration date:** 10/20/2016
- **Last updated:** 01/24/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3409923 | — | NC |