Organization
CHARLOTTE SURGERY CENTER, LLC
Active
Other names
Charlotte Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS LALLY (CHIEF ADMINISTRATIVE OFFICER)
(704) 377-1647
Entity
Organization
Contact information
Practice address
2825 RANDOLPH RD, CHARLOTTE, NC 28211-1075
(704) 377-1647
Mailing address
2825 RANDOLPH RD, CHARLOTTE, NC 28211-1018
(704) 377-1674
(704) 358-8267
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AS0026
NC
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409842
—
NC
Enumeration date
04/20/2006
Last updated
10/15/2018
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