Provider Demographics
NPI:1104928290
Name:CS CENTER, LLC
Entity type:Organization
Organization Name:CS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-442-4661
Mailing Address - Street 1:3621 RANDOLPH RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1317
Mailing Address - Country:US
Mailing Address - Phone:704-442-4661
Mailing Address - Fax:704-442-4667
Practice Address - Street 1:3621 RANDOLPH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1317
Practice Address - Country:US
Practice Address - Phone:704-442-4661
Practice Address - Fax:704-442-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409930Medicaid
NCPIN7591105OtherAETNA PPO (RANDOLPH)
NC0061ROtherBLUE CROSS - BLUE SHIELD
NCPVN3002479OtherAETNA HMO (RANDOLPH)
NCPIN7591105OtherAETNA PPO (RANDOLPH)