Provider Demographics
NPI:1467402545
Name:CAROLINA DIAGNOSTIC CORPORATION
Entity Type:Organization
Organization Name:CAROLINA DIAGNOSTIC CORPORATION
Other - Org Name:PIEDMONT SLEEP AT GREENSBORO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BILLINGS-MIGNONE
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:336-346-1973
Mailing Address - Street 1:1313 CAROLINA ST
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6000
Mailing Address - Country:US
Mailing Address - Phone:336-346-1973
Mailing Address - Fax:336-275-6381
Practice Address - Street 1:1313 CAROLINA ST
Practice Address - Street 2:SUITE 200A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6000
Practice Address - Country:US
Practice Address - Phone:336-346-1973
Practice Address - Fax:336-275-6381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC113314293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC017FUOtherBCBS OF NC
NC2881820Medicare ID - Type UnspecifiedPROVIDER NUMBER