Provider Demographics
NPI:1518929835
Name:CAROLINA HEALTH CENTERS, INC.
Entity Type:Organization
Organization Name:CAROLINA HEALTH CENTERS, INC.
Other - Org Name:PIEDMONT PHYSICIANS FOR WOMEN
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN OBGYN
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-227-2022
Mailing Address - Street 1:102 KATIE CT
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4068
Mailing Address - Country:US
Mailing Address - Phone:864-227-2022
Mailing Address - Fax:864-227-2791
Practice Address - Street 1:102 KATIE CT
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4068
Practice Address - Country:US
Practice Address - Phone:864-227-2022
Practice Address - Fax:864-227-2791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207V00000X
SC261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC092919Medicaid
SC106762Medicaid
SC106762Medicaid
SC3621Medicare PIN
SC2256Medicare PIN
D17694Medicare UPIN
SC092919Medicaid