Organization
MOORESVILLE HOSPITAL MANAGMENT ASSOCIATES INC
Active
Other names
Surgical Center of Lake Norman
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY PARRY ESQ (SR VP AND GENERAL COUNSEL)
(239) 598-3176
Entity
Organization
Contact information
Practice address
171 FAIRVIEW RD, MOORESVILLE, NC 28117-9500
(704) 660-4010
Mailing address
171 FAIRVIEW RD, MOORESVILLE, NC 28117-9500
(704) 660-4010
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00680
NC BLUE CROSS SURGICENTER
NC
05
—
3409891
—
NC
Enumeration date
06/05/2006
Last updated
02/18/2009
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