Healthcare Provider Details

I. General information

NPI: 1437267788
Provider Name (Legal Business Name): THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 ABBEY PL
CHARLOTTE NC
28209-3731
US

IV. Provider business mailing address

PO BOX 32861
CHARLOTTE NC
28232-2861
US

V. Phone/Fax

Practice location:
  • Phone: 704-512-5333
  • Fax:
Mailing address:
  • Phone: 704-512-6438
  • Fax: 704-512-6485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. CONNIE BONEBRAKE
Title or Position: VP POST ACUTE SERVICES
Credential:
Phone: 704-561-8549