Provider Demographics
NPI:1417137811
Name:CARDIOLOGY ASSOCIATES OF THE CAROLINAS PA
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF THE CAROLINAS PA
Other - Org Name:CARDIOLOGY ASSOCIATES OF THE CAROLINAS, P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TYRA
Authorized Official - Middle Name:P
Authorized Official - Last Name:SEAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-205-1443
Mailing Address - Street 1:3686 BLANKENSHIP DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5005
Mailing Address - Country:US
Mailing Address - Phone:828-205-1444
Mailing Address - Fax:
Practice Address - Street 1:505 E PARKER RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5104
Practice Address - Country:US
Practice Address - Phone:828-434-5812
Practice Address - Fax:828-433-8317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24512207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC75100OtherBLUE CROSS BLUE SHIELD
NC1730290271Medicaid
NC75100OtherBLUE CROSS BLUE SHIELD
NC2327536Medicare PIN