Provider Demographics
NPI:1215263082
Name:NCBH OUTPATIENT ENDOSCOPY CENTER, L.L.C.
Entity type:Organization
Organization Name:NCBH OUTPATIENT ENDOSCOPY CENTER, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-713-0341
Mailing Address - Street 1:101 CHARLOIS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1537
Mailing Address - Country:US
Mailing Address - Phone:336-713-0330
Mailing Address - Fax:336-713-0333
Practice Address - Street 1:101 CHARLOIS BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1537
Practice Address - Country:US
Practice Address - Phone:336-713-0341
Practice Address - Fax:336-713-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical