Provider Demographics
NPI:1235855172
Name:CAROLINA HEALTH ASSOCIATES LLC
Entity Type:Organization
Organization Name:CAROLINA HEALTH ASSOCIATES LLC
Other - Org Name:CAROLINA HEALTH URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-244-9859
Mailing Address - Street 1:3807 WHITE HORSE RD STE D&E
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-5598
Mailing Address - Country:US
Mailing Address - Phone:864-881-2252
Mailing Address - Fax:
Practice Address - Street 1:3807 WHITE HORSE RD STE D & E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-5598
Practice Address - Country:US
Practice Address - Phone:864-881-2252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care