Provider Demographics
NPI:1013002013
Name:CAROLINA BLOOD AND CANCER CARE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:CAROLINA BLOOD AND CANCER CARE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DUNCAN
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-329-7772
Mailing Address - Street 1:1583 HEALTH CARE DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3858
Mailing Address - Country:US
Mailing Address - Phone:803-329-7772
Mailing Address - Fax:803-329-9821
Practice Address - Street 1:1583 HEALTH CARE DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3858
Practice Address - Country:US
Practice Address - Phone:803-329-7772
Practice Address - Fax:803-329-9821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 332B00000X
SCMD 13388332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing Site
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3848Medicaid
SCGP3848Medicaid
SC7834Medicare ID - Type UnspecifiedMEDICARE ID
=========OtherFEDERAL EIN