| Gateway Ambulatory Surgery Center, Llc | |
|
1025 Northeast Gateway Court, Ne Concord NC 28025 | |
| (704) 920-7020 | |
| (704) 920-7063 |
| Full Name | Gateway Ambulatory Surgery Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1025 Northeast Gateway Court, Ne, Concord, North Carolina |
| Authorized Official Name and Position | Robert Bashore (ADMINISTRATOR) |
| Authorized Official Contact | 7049207027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Ambulatory Surgery Center, Llc 1025 Northeast Gateway Court, Ne Concord NC 28025 Ph: (704) 920-7020 | Gateway Ambulatory Surgery Center, Llc 1025 Northeast Gateway Court, Ne Concord NC 28025 Ph: (704) 920-7020 |
| NPI Number | 1689761546 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 06/09/2015 |
| Medicare PECOS PAC ID | 7618985441 |
|---|---|
| Medicare Enrollment ID | O20060405000135 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689761546 | NPI | - | NPPES |
| 3409938 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | AS0070 (North Carolina) | Primary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | 060202 (North Carolina) | Secondary |
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