1427164052 NPI number — CAROLINAS MEDICAL CENTER

Table of content: (NPI 1427164052)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427164052 NPI number — CAROLINAS MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAROLINAS MEDICAL CENTER
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:
1427164052
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 602452
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:
28260-2452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-446-0902
Provider Business Mailing Address Fax Number:
704-446-0968

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
251 EASTWAY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28213-7103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-446-0902
Provider Business Practice Location Address Fax Number:
704-446-0968
Provider Enumeration Date:
08/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MABE
Authorized Official First Name:
DON
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF PHARMACY OFFICER
Authorized Official Telephone Number:
704-512-6967

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 608983 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3435193 . This is a "NABP#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7Z1138 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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