Provider Demographics
NPI:1215573233
Name:CAROLINA CARDIAC CARE
Entity type:Organization
Organization Name:CAROLINA CARDIAC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, RDCS, RVT
Authorized Official - Phone:803-845-0404
Mailing Address - Street 1:600 WESTMORELAND RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-6880
Mailing Address - Country:US
Mailing Address - Phone:803-845-0404
Mailing Address - Fax:
Practice Address - Street 1:600 WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-6880
Practice Address - Country:US
Practice Address - Phone:803-845-0404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty