Healthcare Provider Details

I. General information

NPI: 1790727550
Provider Name (Legal Business Name): CAROLINAS REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BLYTHE BLVD
CHARLOTTE NC
28203-5814
US

IV. Provider business mailing address

PO BOX 32861
CHARLOTTE NC
28232-2861
US

V. Phone/Fax

Practice location:
  • Phone: 704-355-4300
  • Fax: 704-355-4231
Mailing address:
  • Phone: 704-512-6438
  • Fax: 704-512-6485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License NumberH0071-C
License Number StateNC

VIII. Authorized Official

Name: MR. ANTHONY DEFURIO
Title or Position: EXECUTIVE VP
Credential:
Phone: 704-355-2154