Provider Demographics
NPI:1750767893
Name:CHAMBERLIN HEALTH, INC
Entity type:Organization
Organization Name:CHAMBERLIN HEALTH, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CHAMBERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-629-7017
Mailing Address - Street 1:350 N COX ST STE 12
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5514
Mailing Address - Country:US
Mailing Address - Phone:336-629-7017
Mailing Address - Fax:336-629-3452
Practice Address - Street 1:350 N COX ST STE 12
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5514
Practice Address - Country:US
Practice Address - Phone:336-629-7017
Practice Address - Fax:336-629-3452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7921892Medicaid