Provider Demographics
NPI:1942525613
Name:CAROLINA ARTHRITIS ALLERGY & RHEUMATOLOGY EVAL & TRMT CTR PA
Entity Type:Organization
Organization Name:CAROLINA ARTHRITIS ALLERGY & RHEUMATOLOGY EVAL & TRMT CTR PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-954-1404
Mailing Address - Street 1:1631 MIDTOWN PL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-1300
Mailing Address - Country:US
Mailing Address - Phone:919-954-1404
Mailing Address - Fax:919-954-1192
Practice Address - Street 1:1631 MIDTOWN PL
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-1300
Practice Address - Country:US
Practice Address - Phone:919-954-1404
Practice Address - Fax:919-954-1192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26292261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC50075OtherBCBS
NC8950075Medicaid
NC8950075Medicaid