Provider Demographics
NPI:1366558959
Name:CAROLINAS MEDICAL CENTER
Entity type:Organization
Organization Name:CAROLINAS MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP PHARMACY SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:MABE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MBA, MHA
Authorized Official - Phone:704-512-6967
Mailing Address - Street 1:PO BOX 602452
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2452
Mailing Address - Country:US
Mailing Address - Phone:704-446-1400
Mailing Address - Fax:704-446-1410
Practice Address - Street 1:1350 S KINGS DR STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2134
Practice Address - Country:US
Practice Address - Phone:704-446-1400
Practice Address - Fax:704-446-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0607556Medicaid
SC7Z1135Medicaid
3427588OtherNCPDP