1902128903 NPI number — CAROLINA SPINE & NEUROSURGERY CENTER PA

Table of content: (NPI 1902128903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902128903 NPI number — CAROLINA SPINE & NEUROSURGERY CENTER PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAROLINA SPINE & NEUROSURGERY CENTER PA
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:
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:
1902128903
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 25370
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28813-1370
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-255-7776
Provider Business Mailing Address Fax Number:
828-274-5134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 MEDICAL COURT SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28752-4972
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-255-7776
Provider Business Practice Location Address Fax Number:
828-274-5134
Provider Enumeration Date:
02/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
FLEMING
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
828-255-7776

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com