Provider Demographics
NPI:1104246826
Name:CARTER'S CIRCLE OF CARE, INC
Entity type:Organization
Organization Name:CARTER'S CIRCLE OF CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-271-5888
Mailing Address - Street 1:2031 MARTIN LUTHER KING JR DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3342
Mailing Address - Country:US
Mailing Address - Phone:336-271-5888
Mailing Address - Fax:
Practice Address - Street 1:2031 MARTIN LUTHER KING JR DR
Practice Address - Street 2:SUITE A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3342
Practice Address - Country:US
Practice Address - Phone:336-271-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty