MEDICARE: CAROLINAS HEALTH SPECIALISTS 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1649956897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINAS HEALTH SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	123 CLARET CUP WAY
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-8204
Country	:	US
Telephone Number	:	610-564-2034
Fax Number	:

Provider Business Practice Location Address
First Line	:	1540 AMERICAN DR
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29505-6072
Country	:	US
Telephone Number	:	610-564-2034
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	SUSAN HAYES
Credential	:	CPC
Telephone Number	:	843-292-0600

Provider Enumeration Date	:	06/23/2023
Last Update Date	:	06/23/2023

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