Provider Demographics
NPI:1093490286
Name:CAROLINA HEALTH CENTERS, INC.
Entity Type:Organization
Organization Name:CAROLINA HEALTH CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:GILMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-941-8121
Mailing Address - Street 1:313 MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-2757
Mailing Address - Country:US
Mailing Address - Phone:864-330-8240
Mailing Address - Fax:864-943-1120
Practice Address - Street 1:442 PROFESSIONAL PARK RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-7626
Practice Address - Country:US
Practice Address - Phone:864-330-8240
Practice Address - Fax:864-943-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty