Organization
SURGICAL CENTER OF GREENSBORO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER GRAHAM (CHIEF ADMINISTRATIVE OFFICER)
(336) 272-0012
Entity
Organization
Contact information
Practice address
705 GREEN VALLEY RD, GREENSBORO, NC 27408-7019
(336) 272-0012
(336) 544-2150
Mailing address
705 GREEN VALLEY RD, GREENSBORO, NC 27408-7019
(336) 272-0012
(336) 544-2150
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AS0018
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409923
—
NC
Enumeration date
10/20/2016
Last updated
01/24/2019
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