Provider Demographics
NPI:1588978290
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:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-732-5501
Mailing Address - Street 1:PO BOX 602456
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2456
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:441 MCALISTER ROAD
Practice Address - Street 2:SUITE 1100B
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-0000
Practice Address - Country:US
Practice Address - Phone:980-212-6250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CHARLOTTE MECKLENBURG HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-05
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2347891DMedicare PIN