Provider Demographics
NPI:1376914283
Name:DIGESTIVE HEALTH ENDOSCOPY CENTER
Entity Type:Organization
Organization Name:DIGESTIVE HEALTH ENDOSCOPY CENTER
Other - Org Name:ALL-AMERICAN ANESTHESIA, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MITTIE
Authorized Official - Middle Name:CANADY
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:BC,CPCS
Authorized Official - Phone:910-323-2477
Mailing Address - Street 1:PO BOX 63256
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3256
Mailing Address - Country:US
Mailing Address - Phone:910-323-2477
Mailing Address - Fax:
Practice Address - Street 1:3202 BOONE TRL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306
Practice Address - Country:US
Practice Address - Phone:910-323-2477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty