MEDICARE: PLAZA FAMILY CHIROPRACTIC CENTER, P.A.

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	111N00000X	Chiropractor	1963	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0823F	OTHER	NC	BCBS OF NC
3	1427015353	OTHER	NC	NPI # UNDER SSN
4	YTM279406	OTHER	NC	ANTHEM BCBS

General Provider Information

NPI Number	:	1811084049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAZA FAMILY CHIROPRACTIC CENTER, P.A.

Provider Business Mailing Address
First Line	:	303 PLAZA DR
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-6716
Country	:	US
Telephone Number	:	252-756-6111
Fax Number	:	252-756-6904

Provider Business Practice Location Address
First Line	:	303 PLAZA DR
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-6716
Country	:	US
Telephone Number	:	252-756-6111
Fax Number	:	252-756-6904

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. THOMAS C. SCHWARTZ
Credential	:	D.C.
Telephone Number	:	252-756-6111

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	02/04/2010

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