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Contact Information

CAROLINA SPECIALTY CARE,PA
124 SUNSET HILL DR
STATESVILLE, NC28625-2729
 Phone: 704-872-8711
 Fax: 704-872-5866
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for CAROLINA SPECIALTY CARE,PA

NPI Number 1063559193
LBN Legal business name CAROLINA SPECIALTY CARE,PA
Authorized official ROBERT WODECKI - (VICE -PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/30/2007
Last updated 07/16/2009 - About 17 years ago
Identifiers
NC License # 930036
NC Medicaid 89014TM
NC Medicaid 89016CP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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