Healthcare Provider Details

I. General information

NPI: 1417876004
Provider Name (Legal Business Name): UROLOGY SPECIALISTS OF THE CAROLINAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 N ELAM AVE FL 2
GREENSBORO NC
27403-1157
US

IV. Provider business mailing address

509 N ELAM AVE FL 2
GREENSBORO NC
27403-1157
US

V. Phone/Fax

Practice location:
  • Phone: 336-274-1114
  • Fax: 336-274-9638
Mailing address:
  • Phone: 336-274-1114
  • Fax: 336-274-9638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KELLY WALTON HEMBREE
Title or Position: SENIOR FINANCIAL ANALYST
Credential:
Phone: 704-248-3400