Organization
DIGESTIVE HEALTH ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITTIE CANADY ELLIOTT (OPERATIONS MANAGER)
(910) 323-2477
Entity
Organization
Contact information
Practice address
3202 BOONE TRL, FAYETTEVILLE, NC 28306
(910) 323-2477
Mailing address
PO BOX 87388, FAYETTEVILLE, NC 28304-7388
(910) 323-2477
(910) 323-1913
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
ASO123
NC
261QE0800X
Endoscopy Clinic/Center
Primary
ASO123
NC
Other
Enumeration date
04/09/2013
Last updated
05/30/2018
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