Organization
CAROLINA SURGERY CENTER LLC
Active
Other names
Surgery Center at Edgewater CRNA Group
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG ARBOUR (CEO)
(803) 286-1481
Entity
Organization
Contact information
Practice address
2536 LENGERS WAY, FORT MILL, SC 29707-7126
(803) 802-9500
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8053845
—
NC
01
—
DR3018
RR MEDICARE
SC
05
—
GP5434
—
SC
Enumeration date
05/04/2010
Last updated
06/03/2011
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