Provider Demographics
NPI:1851712582
Name:CAROLINAS MEDICAL CENTER
Entity Type:Organization
Organization Name:CAROLINAS MEDICAL CENTER
Other - Org Name:CMC LCI RADIATION THERAPY PINEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CMC LINCOLN
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:W
Authorized Official - Last Name:ACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-212-1000
Mailing Address - Street 1:PO BOX 601372
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1372
Mailing Address - Country:US
Mailing Address - Phone:704-667-0337
Mailing Address - Fax:
Practice Address - Street 1:10650 PARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8538
Practice Address - Country:US
Practice Address - Phone:704-667-0337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINAS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-24
Last Update Date:2013-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty