Provider Demographics
NPI:1487794996
Name:ADVANCED CARDIOVASCULAR SERVICES,PA
Entity type:Organization
Organization Name:ADVANCED CARDIOVASCULAR SERVICES,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAJMANI
Authorized Official - Middle Name:
Authorized Official - Last Name:HARWANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-273-3335
Mailing Address - Street 1:200 E NORTHWOOD ST
Mailing Address - Street 2:SUITE 504
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1224
Mailing Address - Country:US
Mailing Address - Phone:336-273-3335
Mailing Address - Fax:336-273-3315
Practice Address - Street 1:200 E NORTHWOOD ST
Practice Address - Street 2:SUITE 504
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1224
Practice Address - Country:US
Practice Address - Phone:336-273-3335
Practice Address - Fax:336-273-3315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600940207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18685OtherPARTNERS
NC25-02502OtherUNITED HEALTH CARE
NC890202JMedicaid
NC242777OtherMAMSI
NC7247000-001OtherCIGNA
NC0202JOtherBCBS GROUP
NC38107OtherBCNS INDIVIDUAL
NC8938107Medicaid
NCF29667Medicare UPIN
NC18685OtherPARTNERS