Marlboro Gastroenterology Associates PA
Organization Active NPI Ambulatory Surgical Clinic/Center · Hamlet, NC
NPI 1609940352 · NPPES record last updated Jun 17, 2008
Key facts
- NPI
- 1609940352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- AS0083 (NC)
- Legal business name
- MARLBORO GASTROENTEROLOGY ASSOCIATES PA
- Practice address
- 102 Endo LN
Suite 1
Hamlet, NC 28345-4560 - Phone
- (910) 582-3636
- Fax
- (910) 205-2251
- NPI assigned
- Nov 17, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- MARLBORO GASTROENTEROLOGY ASSOCIATES PA
Authorized official
- Name
- Mrs. Patricia J Riddle
- Title
- Administrator
- Phone
- (843) 479-9794
Parent organization (reported in NPPES) 1
National Provider Directory
- Part of
- Marlboro Gastroenterolo
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | AS0083 | NC | Yes |
| Endoscopy Clinic/Center | 261QE0800X | AS0083 | NC |
Addresses
Primary practice location
102 Endo LN
Suite 1
Hamlet, NC 28345-4560
Mailing address
PO Box 617
Bennettsville, SC 29512-0617
Phone (843) 479-9794
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3409943 | Medicaid | NC | |
| P00364907 | Other | NC | RR MEDICARE |
Other names
- MARLBORO GI ENDOSCOPY CENTER
Other providers in Hamlet, NC
- Katherine Elizabeth Luebke
- Hector Luis Luna
- Laura Marie Macri
- Siddharth Ved Malhotra
- Charlita Mangrum
- Marlboro Gastroenterology Associates PA
- Pam Marsh
- Harold L Martin
- Jennie Davis Maultsby
- Monteeia Shanta McDonald
All providers in Hamlet, NC · Ambulatory Surgical Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.