Provider Demographics
NPI:1871865873
Name:NORTHCROSS NEPHROLOGY CENTER P.C
Entity Type:Organization
Organization Name:NORTHCROSS NEPHROLOGY CENTER P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:EANNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-895-3415
Mailing Address - Street 1:16501B NORTHCROSS DR STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5081
Mailing Address - Country:US
Mailing Address - Phone:704-895-3415
Mailing Address - Fax:704-895-3416
Practice Address - Street 1:16501B NORTHCROSS DR STE B
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5081
Practice Address - Country:US
Practice Address - Phone:704-895-3415
Practice Address - Fax:704-895-3416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty