Provider Demographics
NPI:1073046900
Name:HPS CAROLINAS
Entity Type:Organization
Organization Name:HPS CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-248-7562
Mailing Address - Street 1:4108 PARK ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9735 KINCEY AVE STE 302
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-9120
Practice Address - Country:US
Practice Address - Phone:877-884-4438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty