Provider Demographics
NPI:1669701306
Name:DRX HIGH POINT, PLLC
Entity type:Organization
Organization Name:DRX HIGH POINT, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-884-4050
Mailing Address - Street 1:2305 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7830
Mailing Address - Country:US
Mailing Address - Phone:336-884-4050
Mailing Address - Fax:336-885-0505
Practice Address - Street 1:2305 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7830
Practice Address - Country:US
Practice Address - Phone:336-884-4050
Practice Address - Fax:336-885-4050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200501450261QP2300X
332B00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2075562OtherMEDICARE PTAN