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WAVECO LLC NPI 1760418917


NPI Information

NPI: 1760418917
Provider Name: WAVECO LLC

Doing Business As: CAROLINA CENTER FOR SPECIALTY SURGERY

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 34D1056490

Address:
1822 BRUNSWICK AVE
CHARLOTTE, NC
ZIP 28207
Phone: (704) 831-4400
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WAVECO LLC is an ambulatory surgical clinic center in Charlotte, NC. WAVECO LLC NPI is 1760418917. The provider is registered as an organization entity type.
The provider Is Doing Business As Carolina Center For Specialty Surgery.

The provider's business location address is:

1822 BRUNSWICK AVE
CHARLOTTE, NC
ZIP 28207-820
Phone: (704) 831-4400
Fax: (704) 831-4401

The provider's authorized official is Mary S Cloninger .
The authorized official title is Member Board Of Directors and has the following contact phone number (704) 376-1605.

The CLIA number assigned to this NPI record is 34D1056490 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2006 and was last updated on 4/30/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory SurgicalAS0058NORTH CAROLINAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11760418917MEDICAIDNORTH CAROLINA
22380827MEDICARE PINNORTH 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: 11/14/2023

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