Provider Demographics
NPI:1427026160
Name:CAROLINA RESPIRATORY SPECIALISTS LLP
Entity Type:Organization
Organization Name:CAROLINA RESPIRATORY SPECIALISTS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:AVANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-540-2179
Mailing Address - Street 1:PO BOX 471008
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28247-1008
Mailing Address - Country:US
Mailing Address - Phone:704-540-2179
Mailing Address - Fax:704-543-6017
Practice Address - Street 1:10036 PARK CEDAR DR
Practice Address - Street 2:SUITE A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8914
Practice Address - Country:US
Practice Address - Phone:704-540-2179
Practice Address - Fax:704-543-6017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890176HMedicaid
NC2312989Medicare ID - Type Unspecified