Healthcare Provider Details

I. General information

NPI: 1508537176
Provider Name (Legal Business Name): CAROLINA BLOOD AND CANCER CARE ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 09/23/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1583 HEALTH CARE DR
ROCK HILL SC
29732-3858
US

IV. Provider business mailing address

1583 HEALTH CARE DR
ROCK HILL SC
29732-3858
US

V. Phone/Fax

Practice location:
  • Phone: 803-329-7772
  • Fax: 803-329-9821
Mailing address:
  • Phone: 803-329-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: KASHYAP B PATEL
Title or Position: CEO
Credential:
Phone: 803-329-7772