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General NPI Number Information
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NPI Number | 1548337702
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Entity Type | Organization
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Legal Business Name | CHARLOTTE'S PREMIERE HEALTHCARE
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 3230 PROSPERITY CHURCH RD SUITE 101
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City | CHARLOTTE
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State | NC
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Zip | 28269-8251
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Country | US
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Telephone | 704-510-4366
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Fax | 704-510-4347
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Provider Business Mailing Address
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Address Line | 3230 PROSPERITY CHURCH RD SUITE 101
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City | CHARLOTTE
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State | NC
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Zip | 28269-8251
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Country | US
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Telephone | 704-510-4366
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Fax | 704-510-4347
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CAROL ANNE RUPE
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Credential | M.D.
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Telephone | 704-510-4366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36420
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License Number State | NC
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