Provider Demographics
NPI:1467810663
Name:LEGACY HEART CARE OF CHARLOTTE, LLC
Entity Type:Organization
Organization Name:LEGACY HEART CARE OF CHARLOTTE, LLC
Other - Org Name:FLOW THERAPY CHARLOTTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-423-4400
Mailing Address - Street 1:300 BILLINGSLEY RD
Mailing Address - Street 2:STE 101
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1075
Mailing Address - Country:US
Mailing Address - Phone:704-334-1401
Mailing Address - Fax:704-334-1471
Practice Address - Street 1:300 BILLINGSLEY RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1084
Practice Address - Country:US
Practice Address - Phone:817-423-4400
Practice Address - Fax:817-423-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty