Healthcare Provider Details

I. General information

NPI: 1508821158
Provider Name (Legal Business Name): MEDCATH PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 ROOSEVELT BLVD SUITE 220
PHILADELPHIA PA
19152-2012
US

IV. Provider business mailing address

10720 SIKES PL SUITE 300
CHARLOTTE NC
28277-8141
US

V. Phone/Fax

Practice location:
  • Phone: 215-331-1366
  • Fax: 215-331-1006
Mailing address:
  • Phone: 704-815-7789
  • Fax: 888-401-6931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. GARY GUIDRY
Title or Position: CEO
Credential:
Phone: 704-815-7804