Provider Demographics
NPI:1386067551
Name:THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRIEDA
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:LOWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-403-1780
Mailing Address - Street 1:200 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 430
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0939
Mailing Address - Country:US
Mailing Address - Phone:704-403-6900
Mailing Address - Fax:704-403-6949
Practice Address - Street 1:200 MEDICAL PARK DR
Practice Address - Street 2:SUITE 430
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0939
Practice Address - Country:US
Practice Address - Phone:704-403-6900
Practice Address - Fax:704-403-6949
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC904Medicare PIN