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General NPI Number Information
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NPI Number | 1336492008
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Entity Type | Organization
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Legal Business Name | THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 447 MCALISTER RD STE 1600
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City | LINCOLNTON
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State | NC
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Zip | 28092-4114
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Country | US
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Telephone | 980-212-5100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19305
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City | CHARLOTTE
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State | NC
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Zip | 28219-9305
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Country | US
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Telephone | 704-631-0002
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Fax |
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Authorized Official
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Title or Position | ENTERPRISE EVP
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Name | SCOTT RISSMILLER
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Credential |
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Telephone | 704-355-8675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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