Healthcare Provider Details

I. General information

NPI: 1316251978
Provider Name (Legal Business Name): PARDEE FAMILY MEDICINE ASSOCIATES-BAT CAVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 08/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 LAKE LURE HWY
BAT CAVE NC
28710-0290
US

IV. Provider business mailing address

PO BOX 63314
CHARLOTTE NC
28263-3314
US

V. Phone/Fax

Practice location:
  • Phone: 828-625-2322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALAN D HOUSE
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CFO
Phone: 828-696-1000