Provider Demographics
NPI:1245023654
Name:WAKE FOREST AMBULATORY VENTURES, LLC
Entity type:Organization
Organization Name:WAKE FOREST AMBULATORY VENTURES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, VP
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-716-3335
Mailing Address - Street 1:600 N LINDSAY ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4306
Mailing Address - Country:US
Mailing Address - Phone:336-878-6068
Mailing Address - Fax:336-878-6111
Practice Address - Street 1:600 N LINDSAY ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4306
Practice Address - Country:US
Practice Address - Phone:336-878-6068
Practice Address - Fax:336-878-6111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAKE FOREST AMBULATORY VENTURES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical