IREDELL HEAD NECK AND EAR AMBULATORY SURGERY CENTER INC. NPI 1710956529

NPI Information

NPI: 1710956529
Provider Name: IREDELL HEAD, NECK AND EAR AMBULATORY SURGERY CENTER, INC.
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
707 BRYANT ST
LOWER LEVEL
STATESVILLE, NC
ZIP 28677
Phone: (704) 873-5224
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IREDELL HEAD, NECK AND EAR AMBULATORY SURGERY CENTER, INC. is an ambulatory surgical clinic center in Statesville, NC. IREDELL HEAD, NECK AND EAR AMBULATORY SURGERY CENTER, INC. NPI is 1710956529. The provider is registered as an organization entity type.

The provider's business location address is:

707 BRYANT ST
LOWER LEVEL
STATESVILLE, NC
ZIP 28677-142
Phone: (704) 873-5224
Fax: (704) 924-8378

The provider's authorized official is Mark L. Prendergast .
The authorized official title is Physician Director and has the following contact phone number (704) 873-5224.

The enumeration date for this NPI number is 3/15/2006 and was last updated on 2/18/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	AS0042	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2380603	MEDICARE ID-TYPE UNSPECIFIED	NORTH CAROLINA	GROUP NUMBER
2	3409865	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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