Provider Demographics
NPI:1982178042
Name:LANGTREE ENDOSCOPY CENTER, LLC
Entity type:Organization
Organization Name:LANGTREE ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO-CREDENTIALLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7377
Mailing Address - Street 1:106 ALEXANDER BANK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9624
Mailing Address - Country:US
Mailing Address - Phone:704-660-2651
Mailing Address - Fax:704-663-6521
Practice Address - Street 1:106 ALEXANDER BANK DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117
Practice Address - Country:US
Practice Address - Phone:704-660-2651
Practice Address - Fax:704-663-6521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical