# CHARLOTTE SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CHARLOTTE SURGERY CENTER, LLC
- **Other names:** Charlotte Surgery Center-Wendover Campus
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124594338
- **Legal business name:** CHARLOTTE SURGERY CENTER, LLC
- **Authorized official:** THOMAS JAMES LALLY (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (704) 377-1647

## Contact information

- **Practice address:** 3621 RANDOLPH RD STE 200, CHARLOTTE, NC 28211-0027
- **Practice address phone:** (704) 377-1647
- **Mailing address:** 3621 RANDOLPH RD STE 200, CHARLOTTE, NC 28211-0027
- **Mailing address phone:** (704) 377-1647

## Taxonomy

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

## Other

- **Enumeration date:** 10/16/2018
- **Last updated:** 10/16/2018