Provider Demographics
NPI:1093948762
Name:AA MANAGEMENT CORP INC
Entity Type:Organization
Organization Name:AA MANAGEMENT CORP INC
Other - Org Name:AA PRIME CARE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VAHE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHAJANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-535-5530
Mailing Address - Street 1:401 HAWTHORNE LN
Mailing Address - Street 2:110-121
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204
Mailing Address - Country:US
Mailing Address - Phone:704-535-5530
Mailing Address - Fax:704-535-5537
Practice Address - Street 1:5225 ALBEMARLE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-3604
Practice Address - Country:US
Practice Address - Phone:704-535-5530
Practice Address - Fax:704-535-5537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-28
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002-00125173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5913446Medicaid
NC2327518AOtherMEDICARE