CHARLOTTE COMMUNITY HEALTH CLINIC INC. NPI 1215499520

NPI Information

CHARLOTTE COMMUNITY HEALTH CLINIC, INC. is a federally qualified health center (fqhc) clinic center in Charlotte, NC. CHARLOTTE COMMUNITY HEALTH CLINIC, INC. NPI is 1215499520. The provider is registered as an organization entity type.

The provider's business location address is:

5301 WILKINSON BLVD STE 1105
CHARLOTTE, NC
ZIP 28208-455
Phone: (704) 316-6573
Fax: (704) 384-1977

The provider's authorized official is Lisa M Holmes .
The authorized official title is Coo and has the following contact phone number (704) 316-6561.

The CLIA number assigned to this NPI record is 34D1054068 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/4/2019 and was last updated on 5/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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