Provider Demographics
NPI:1265407175
Name:CAROLINAS ANSON HEALTHCARE INC.
Entity type:Organization
Organization Name:CAROLINAS ANSON HEALTHCARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-695-3402
Mailing Address - Street 1:2301 US HIGHWAY 74 W
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-7554
Mailing Address - Country:US
Mailing Address - Phone:704-994-4500
Mailing Address - Fax:704-994-4501
Practice Address - Street 1:2301 US HIGHWAY 74 W
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-7554
Practice Address - Country:US
Practice Address - Phone:704-994-4500
Practice Address - Fax:704-994-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1119251E00000X
NCH0082282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC407241Medicaid
NC3408242OtherCAP
NC0045047Medicaid
SC134684Medicaid
NC3400084Medicaid
SCNPA952Medicaid
SCNPA952Medicaid
NC340084Medicare Oscar/Certification