Provider Demographics
NPI:1386158616
Name:CAROLINA ELITE WOMEN'S CARE
Entity type:Organization
Organization Name:CAROLINA ELITE WOMEN'S CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-977-7095
Mailing Address - Street 1:934 VANDORA SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-3544
Mailing Address - Country:US
Mailing Address - Phone:919-977-7095
Mailing Address - Fax:919-977-9289
Practice Address - Street 1:934 VANDORA SPRINGS RD
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-3544
Practice Address - Country:US
Practice Address - Phone:919-977-7095
Practice Address - Fax:919-977-9289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-22
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty