Organization
GATEWAY AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BASHORE (ADMINISTRATOR)
(704) 920-7027
Entity
Organization
Contact information
Practice address
1025 NORTHEAST GATEWAY COURT, NE, CONCORD, NC 28025
(704) 920-7020
(704) 920-7063
Mailing address
1025 NORTHEAST GATEWAY COURT, NE, CONCORD, NC 28025
(704) 920-7020
(704) 920-7063
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
AS0070
NC
261QA1903X
Ambulatory Surgical Clinic/Center
060202
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409938
—
NC
Enumeration date
10/10/2006
Last updated
06/09/2015
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