OrganizationOwen Drive Surgical Clinic Of Fayetteville PllcSurgeryAllopathic & Osteopathic PhysiciansPractice Address513 Owen Dr, Fayetteville, NC 28304-3433(910) 323-0101PECOS EnrollmentBased on the most recent information from CMS, provider Owen Drive Surgical Clinic Of Fayetteville Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1598841868Provider TypeOrganizationFull NameOwen Drive Surgical Clinic Of Fayetteville PllcSubpartNoEnumeration Date10/31/2006Last Updated8/22/2020Contact InformationPractice LocationPractice Address513 Owen Dr, Fayetteville, NC 28304-3433Phone(910) 323-0101Fax(910) 484-2654Mailing LocationMailing Address513 Owen Dr, Fayetteville, NC 28304-3433Phone(910) 323-0101Fax(910) 484-2654Authorized OfficialNamePere, Bunny Marie (Office Manager)Phone(910) 323-0101Provider TaxonomiesCodeDescriptionLicenseCode208600000XPrimaryDescriptionSurgeryAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID017XCDescriptionOtherIssuerBCBSNorth Carolina