Provider Demographics
NPI:1285927640
Name:THE BAND CENTER OF THE CAROLINAS, PA
Entity type:Organization
Organization Name:THE BAND CENTER OF THE CAROLINAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:L
Authorized Official - Last Name:BULL
Authorized Official - Suffix:
Authorized Official - Credentials:ST
Authorized Official - Phone:877-655-2263
Mailing Address - Street 1:400 ASHVILLE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6134
Mailing Address - Country:US
Mailing Address - Phone:877-655-2263
Mailing Address - Fax:919-233-1685
Practice Address - Street 1:400 ASHVILLE AVE STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6134
Practice Address - Country:US
Practice Address - Phone:877-655-2263
Practice Address - Fax:919-233-1685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC165057208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty