Provider Demographics
NPI:1780046110
Name:CAROLINAS MEDICAL CENTER AT HOME, LLC
Entity Type:Organization
Organization Name:CAROLINAS MEDICAL CENTER AT HOME, LLC
Other - Org Name:ATRIUM HEALTH AT HOME UNIVERSITY CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:STOLZENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-512-2312
Mailing Address - Street 1:PO BOX 602259
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2259
Mailing Address - Country:US
Mailing Address - Phone:704-512-2308
Mailing Address - Fax:
Practice Address - Street 1:101 EAST W.T. HARRIS BLVD,
Practice Address - Street 2:BLDG 5000, SUITE 5105
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262
Practice Address - Country:US
Practice Address - Phone:704-863-5280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4677251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health