Provider Demographics
NPI:1407811987
Name:RAO MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:RAO MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:BISHOP-KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-897-5521
Mailing Address - Street 1:901 DENIM DR
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:NC
Mailing Address - Zip Code:28339-2307
Mailing Address - Country:US
Mailing Address - Phone:910-897-5521
Mailing Address - Fax:910-897-2003
Practice Address - Street 1:901 DENIM DR
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:NC
Practice Address - Zip Code:28339-2307
Practice Address - Country:US
Practice Address - Phone:910-897-5521
Practice Address - Fax:910-897-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2024880AMedicare ID - Type Unspecified