1326223892 NPI number — CAROLINAS MEDICAL CENTER AT HOME LLC

Table of content: JOHN SANDY (NPI 1891390977)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326223892 NPI number — CAROLINAS MEDICAL CENTER AT HOME LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAROLINAS MEDICAL CENTER AT HOME LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326223892
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 602259
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28260-2259
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-512-5215
Provider Business Mailing Address Fax Number:
704-512-2428

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
853 S LAUREL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLNTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28092-3642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-512-2300
Provider Business Practice Location Address Fax Number:
704-561-8532
Provider Enumeration Date:
01/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
STOLZENBACH
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
704-512-2312

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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