Provider Demographics
NPI:1215997473
Name:CAROHEALTH ASSOCIATES, PLLC
Entity type:Organization
Organization Name:CAROHEALTH ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-509-0933
Mailing Address - Street 1:2225 EAST W.T. HARRIS BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-5138
Mailing Address - Country:US
Mailing Address - Phone:704-509-0933
Mailing Address - Fax:704-509-0934
Practice Address - Street 1:2225 EAST W.T. HARRIS BLVD
Practice Address - Street 2:STE B
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-5138
Practice Address - Country:US
Practice Address - Phone:704-509-0933
Practice Address - Fax:704-509-0934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC87997208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC200002210540OtherNC PRIVILEGE LICENSE