MEDICARE: CAROLINAS IMAGING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist
2	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1093765851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINAS IMAGING SERVICES LLC

Provider Business Mailing Address
First Line	:	700 E MOREHEAD ST STE 300
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28202-2742
Country	:	US
Telephone Number	:	704-362-5391
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 OLIN WAY STE 1100
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-9250
Country	:	US
Telephone Number	:	704-464-5704
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF CREDENTIALING
Name	:	KATRINA ROELLE
Credential	:
Telephone Number	:	614-689-1691

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	04/07/2026

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