# SOUTHPARK SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SouthPark Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811940141
- **Authorized official:** FRED M HARGETT (EVP CFO)
- **Authorized official phone:** (704) 384-5184

## Contact information

- **Practice address:** 6035 FAIRVIEW RD, STE 300, CHARLOTTE, NC 28210-3256
- **Practice address phone:** (704) 295-3000
- **Mailing address:** 2085 FRONTIS PLAZA BLVD, WINSTON-SALEM, NC 27103-5614
- **Mailing address phone:** (336) 277-7226
- **Mailing address fax:** (336) 277-9795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | AS0032 | NC | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 10/26/2010