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General NPI Number Information
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NPI Number | 1902895675
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Entity Type | Organization
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Legal Business Name | CAROMONT HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 2511 COURT DR
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City | GASTONIA
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State | NC
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Zip | 28054-2140
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Country | US
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Telephone | 704-671-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 2511 COURT DR
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City | GASTONIA
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State | NC
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Zip | 28054-2140
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Country | US
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Telephone | 704-671-5600
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Fax |
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Authorized Official
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Title or Position | VP CHIEF FINANCIAL OFFICER
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Name | MR. DAVID O'CONNOR
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Credential |
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Telephone | 704-834-2049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | AS0037
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License Number State | NC
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