Provider Demographics
NPI:1407200769
Name:CSFA PRO LLC
Entity type:Organization
Organization Name:CSFA PRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:FRASE
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:828-577-3313
Mailing Address - Street 1:364 ROCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ZIRCONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28790-3600
Mailing Address - Country:US
Mailing Address - Phone:828-577-3313
Mailing Address - Fax:
Practice Address - Street 1:125 COMMONWEALTH DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4812
Practice Address - Country:US
Practice Address - Phone:864-675-4539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC165324282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital