Healthcare Provider Details

I. General information

NPI: 1275689382
Provider Name (Legal Business Name): CAROLINA BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 N ELM ST
HIGH POINT NC
27262-3918
US

IV. Provider business mailing address

712 N ELM ST
HIGH POINT NC
27262-3918
US

V. Phone/Fax

Practice location:
  • Phone: 336-889-5422
  • Fax: 336-889-3202
Mailing address:
  • Phone: 336-889-5422
  • Fax: 336-889-3202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberAS0015
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License NumberAS0015
License Number StateNC

VIII. Authorized Official

Name: ROBERT C CRAWFORD
Title or Position: OWNER/ADMINISTRATOR
Credential: M.D.
Phone: 336-889-5422