Provider Demographics
NPI:1942598735
Name:CAROLINA PEDIATRICS AND ADOLESCENT CARE, PA
Entity Type:Organization
Organization Name:CAROLINA PEDIATRICS AND ADOLESCENT CARE, PA
Other - Org Name:CAROLINA PEDIATRICS PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBRIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-256-0531
Mailing Address - Street 1:2113 ADAMS GRV
Mailing Address - Street 2:STE. 103
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6951
Mailing Address - Country:US
Mailing Address - Phone:803-256-0531
Mailing Address - Fax:888-318-5567
Practice Address - Street 1:2113 ADAMS GRV
Practice Address - Street 2:STE. 103
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6951
Practice Address - Country:US
Practice Address - Phone:803-256-0531
Practice Address - Fax:888-318-5567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site