Provider Demographics
NPI:1811084049
Name:PLAZA FAMILY CHIROPRACTIC CENTER, P.A.
Entity type:Organization
Organization Name:PLAZA FAMILY CHIROPRACTIC CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-756-6111
Mailing Address - Street 1:303 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-6716
Mailing Address - Country:US
Mailing Address - Phone:252-756-6111
Mailing Address - Fax:252-756-6904
Practice Address - Street 1:303 PLAZA DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-6716
Practice Address - Country:US
Practice Address - Phone:252-756-6111
Practice Address - Fax:252-756-6904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1963111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890823FMedicaid
NC0823FOtherBCBS OF NC
NC1427015353OtherNPI # UNDER SSN
NCYTM279406OtherANTHEM BCBS
NC890823FMedicaid
NCU49723Medicare UPIN
NC890823FMedicaid