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NPI Code Detail

MEDICARE: CAROLINA MEDICORP ENTERPRISES,INC

MEDICARE: CAROLINA MEDICORP ENTERPRISES,INC
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
1207Q00000XFamily Medicine Physician
2207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1346529500
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLINA MEDICORP ENTERPRISES,INC
Provider Business Mailing Address
First Line : PO BOX 751803
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1803
Country : US
Telephone Number : 704-384-8441
Fax Number : 704-384-8442
Provider Business Practice Location Address
First Line : 9600 E INDEPENDENCE BLVD STE 170
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-4628
Country : US
Telephone Number : 704-384-8441
Fax Number : 704-384-8442
Authorized Official
Title or Position : VP FINANCE
Name : GEOFFREY GARDNER
Credential :
Telephone Number : 704-384-9890
Provider Enumeration Date : 08/05/2011
Last Update Date : 10/02/2017

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Directions to “CAROLINA MEDICORP ENTERPRISES,INC ” Practice Location

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