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Organization
SOUTHPARK SURGERY CENTER LLC
Active
Organization
SOUTHPARK SURGERY CENTER LLC
Active
Other names
SouthPark Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
FRED M HARGETT (EVP CFO)
(704) 384-5184
Entity
Organization
Contact information
Practice address
6035 FAIRVIEW RD, STE 300, CHARLOTTE, NC 28210-3256
(704) 295-3000
Mailing address
2085 FRONTIS PLAZA BLVD, WINSTON-SALEM, NC 27103-5614
(336) 277-7226
(336) 277-9795
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AS0032
NC
Other
Enumeration date
05/18/2006
Last updated
10/26/2010
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