Provider Demographics
NPI:1346628815
Name:CAROLINAS PHYSICIAN NETWORK INC
Entity Type:Organization
Organization Name:CAROLINAS PHYSICIAN NETWORK INC
Other - Org Name:STANLY CENTRAL LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:MARINDY
Authorized Official - Middle Name:B
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-983-7320
Mailing Address - Street 1:PO BOX 601888
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1888
Mailing Address - Country:US
Mailing Address - Phone:704-983-7322
Mailing Address - Fax:704-984-6999
Practice Address - Street 1:320 YADKIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-3447
Practice Address - Country:US
Practice Address - Phone:704-983-7322
Practice Address - Fax:704-984-6999
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINAS PHYSICIANS NETWORK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory