1518493022 NPI number — PRESBYTERIAN SAMEDAY SURGERY CENTER AT HUNTERSVILLE LLC

Table of content: DR. JUDITH BEER PH.D., LCSW (NPI 1295903243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518493022 NPI number — PRESBYTERIAN SAMEDAY SURGERY CENTER AT HUNTERSVILLE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRESBYTERIAN SAMEDAY SURGERY CENTER AT HUNTERSVILLE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518493022
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2085 FRONTIS PLAZA BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINSTON SALEM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27103-5614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-277-7226
Provider Business Mailing Address Fax Number:
336-277-9795

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10030 GILEAD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTERSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28078-7545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-316-4010
Provider Business Practice Location Address Fax Number:
704-316-6706
Provider Enumeration Date:
05/03/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARGETT
Authorized Official First Name:
FRED
Authorized Official Middle Name:
M
Authorized Official Title or Position:
EVP CFO
Authorized Official Telephone Number:
704-384-5184

Provider Taxonomy Codes

  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)