Healthcare Provider Details

I. General information

NPI: 1619831377
Provider Name (Legal Business Name): DAVIDSON CHARTER ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 BIESECKER RD
LEXINGTON NC
27295-1522
US

IV. Provider business mailing address

500 BIESECKER RD
LEXINGTON NC
27295-1522
US

V. Phone/Fax

Practice location:
  • Phone: 336-803-7809
  • Fax:
Mailing address:
  • Phone: 336-803-7809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MRS. MEREDITH COLLINS
Title or Position: LOGISTICS & OPERATIONS SPECIALIST
Credential:
Phone: 336-803-7809