Organization
ENDOSCOPY CENTER -PINEVILLE LLC
Active
Other names
Carolina Endoscopy Center -Pineville
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ROTHROCK (CREDENTIALING COORDINATOR)
(704) 372-7974
Entity
Organization
Contact information
Practice address
10520 PARK RD, SUITE 105, CHARLOTTE, NC 28210-8487
(704) 927-5756
(704) 927-5757
Mailing address
3426 TORINGDON WAY STE 108, CHARLOTTE, NC 28277-3497
(704) 372-7974
(704) 970-4746
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2381097A
MEDICARE, OTHER
NC
Enumeration date
11/14/2006
Last updated
11/20/2023
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