Provider Demographics
NPI:1093993727
Name:CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER
Entity Type:Organization
Organization Name:CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:I
Authorized Official - Last Name:RHOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-243-4749
Mailing Address - Street 1:1032 FLEMING STREET
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3532
Mailing Address - Country:US
Mailing Address - Phone:286-963-0998
Mailing Address - Fax:828-696-3868
Practice Address - Street 1:1032 FLEMING STREET
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3532
Practice Address - Country:US
Practice Address - Phone:286-963-0998
Practice Address - Fax:828-696-3868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAS0106261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical