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General NPI Number Information
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NPI Number | 1457780553
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Entity Type | Organization
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Legal Business Name | CAROLINA CENTER FOR WOMEN
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 421 N WENDOVER RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-1064
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Country | US
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Telephone | 704-367-2255
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Fax | 704-367-1499
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Provider Business Mailing Address
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Address Line | 421 N WENDOVER RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-1064
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Country | US
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Telephone | 704-367-2255
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Fax | 704-367-1499
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MS. SANDY LYNN ST CLAIR
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Credential | OWNER/DIRECTOR
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Telephone | 704-367-2255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | AB0004
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License Number State | NC
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