MEDICARE: CAROLINA PAIN RELIEF CENTER PLLC

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	261Q00000X	Clinic/Center
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1396392197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA PAIN RELIEF CENTER PLLC

Provider Business Mailing Address
First Line	:	2902 TURNER GROVE DR N
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-1977
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4146 MENDENHALL OAKS PKWY STE 105
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8034
Country	:	US
Telephone Number	:	336-740-9580
Fax Number	:	336-790-4182

Authorized Official
Title or Position	:	OWNER
Name	:	FRENESA HALL
Credential	:	MD
Telephone Number	:	336-740-9580

Provider Enumeration Date	:	08/26/2019
Last Update Date	:	09/22/2022

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