Provider Demographics
NPI:1275689382
Name:CAROLINA BIRTH CENTER
Entity Type:Organization
Organization Name:CAROLINA BIRTH CENTER
Other - Org Name:CAROLINA WOMANCARE/ELMSTREET SURGICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-889-5422
Mailing Address - Street 1:712 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3918
Mailing Address - Country:US
Mailing Address - Phone:336-889-5422
Mailing Address - Fax:336-889-3202
Practice Address - Street 1:712 N ELM ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3918
Practice Address - Country:US
Practice Address - Phone:336-889-5422
Practice Address - Fax:336-889-3202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAS0015261QA1903X, 261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409831Medicaid
00612OtherBCBS
NC3409982Medicaid
NC3409982Medicaid