Provider Demographics
NPI:1639496300
Name:CAROLINAS HOSPITALIST GRP
Entity type:Organization
Organization Name:CAROLINAS HOSPITALIST GRP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAR
Authorized Official - Prefix:MS
Authorized Official - First Name:NEDRA
Authorized Official - Middle Name:SHAMALE
Authorized Official - Last Name:DRAKEFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-512-4877
Mailing Address - Street 1:PO BOX 60444
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260
Mailing Address - Country:US
Mailing Address - Phone:704-512-4877
Mailing Address - Fax:704-512-4823
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203
Practice Address - Country:US
Practice Address - Phone:704-512-4877
Practice Address - Fax:704-512-4823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty