Provider Demographics
NPI:1366908469
Name:BRUNSWICK SURGERY CENTER LLC
Entity type:Organization
Organization Name:BRUNSWICK SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:SKIPPER
Authorized Official - Last Name:BURLESON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-660-4601
Mailing Address - Street 1:1168 E CUTLAR XING STE 101
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-6485
Mailing Address - Country:US
Mailing Address - Phone:910-660-4600
Mailing Address - Fax:910-899-9114
Practice Address - Street 1:1168 E CUTLAR XING STE 101
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-6485
Practice Address - Country:US
Practice Address - Phone:910-660-4600
Practice Address - Fax:910-899-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical