Provider Demographics
NPI:1831269687
Name:CAROLINA RADIOLOGY, PA
Entity type:Organization
Organization Name:CAROLINA RADIOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:THARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-794-6884
Mailing Address - Street 1:PO BOX 13445
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24034-3445
Mailing Address - Country:US
Mailing Address - Phone:866-788-9852
Mailing Address - Fax:540-776-6856
Practice Address - Street 1:11550 COMMON OAKS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-7298
Practice Address - Country:US
Practice Address - Phone:910-794-6884
Practice Address - Fax:910-395-6714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94001602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890237CMedicaid
NC2229269BMedicare PIN