Provider Demographics
NPI:1831151539
Name:CAROLINA EAR, NOSE & THROAT-SINUS AND ALLERGY CENTER PA
Entity type:Organization
Organization Name:CAROLINA EAR, NOSE & THROAT-SINUS AND ALLERGY CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:BROOK
Authorized Official - Middle Name:
Authorized Official - Last Name:FULMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-322-2183
Mailing Address - Street 1:256 10TH AVE NE STE C
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3882
Mailing Address - Country:US
Mailing Address - Phone:828-322-2183
Mailing Address - Fax:828-328-2838
Practice Address - Street 1:304 10TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3834
Practice Address - Country:US
Practice Address - Phone:828-322-2183
Practice Address - Fax:828-328-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2995820-001OtherCIGNA
NC890298QMedicaid
NCCK7483OtherRAILROAD MEDICARE NUMBER
NC0298QOtherBCBS
NC3404212Medicaid
NCCK7483OtherRAILROAD MEDICARE NUMBER