NPI: | 1144740028 |
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Name: | DRS FARRELL, FARRELL, NALE, COOK, KAPITAN, MOHAMED, FRANCO, WESSEL, HO |
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Entity Type: | Organization |
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Organization Name: | DRS FARRELL, FARRELL, NALE, COOK, KAPITAN, MOHAMED, FRANCO, WESSEL, HO |
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Other - Org Name: | CAROLINAS CENTER FOR ORAL AND FACIAL SURGERY |
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Other - Org Type: | Doing Business As |
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Authorized Official - Title/Position: | DIRECTOR OF BILLING |
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Authorized Official - Prefix: | |
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Authorized Official - First Name: | JENNIFER |
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Authorized Official - Middle Name: | RAYLE |
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Authorized Official - Last Name: | HOCK |
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Authorized Official - Suffix: | |
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Authorized Official - Credentials: | |
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Authorized Official - Phone: | 704-295-4653 |
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Mailing Address - Street 1: | 5550 77 CENTER DR STE 320 |
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Mailing Address - Street 2: | |
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Mailing Address - City: | CHARLOTTE |
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Mailing Address - State: | NC |
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Mailing Address - Zip Code: | 28217-0739 |
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Mailing Address - Country: | US |
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Mailing Address - Phone: | 704-295-4653 |
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Mailing Address - Fax: | |
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Practice Address - Street 1: | 8840 BLAKENEY PROFESSIONAL DR STE 300 |
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Practice Address - Street 2: | |
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Practice Address - City: | CHARLOTTE |
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Practice Address - State: | NC |
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Practice Address - Zip Code: | 28277-6749 |
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Practice Address - Country: | US |
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Practice Address - Phone: | 704-716-9840 |
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Practice Address - Fax: | |
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EIN: | <UNAVAIL> |
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Is Organization Subpart?: | Yes |
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Parent Organization LBN: | DRS FARRELL, FARRELL, NALE, COOK, KAPITAN, MOHAMED, FRANCO, WESSEL, HO |
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Parent Organization TIN: | <UNAVAIL> |
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Enumeration Date: | 2017-06-22 |
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Last Update Date: | 2022-12-01 |
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Deactivation Date: | |
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Deactivation Code: | |
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Reactivation Date: | |
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