CAROLINA MERCY MEDICAL CLINIC PC NPI 1104154988

NPI Information

NPI: 1104154988
Provider Name: CAROLINA MERCY MEDICAL CLINIC PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 34D0991958

Address:
2101 W FRANKLIN BLVD
GASTONIA, NC
ZIP 28052
Phone: (704) 867-8855
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CAROLINA MERCY MEDICAL CLINIC PC is a primary care clinic center in Gastonia, NC. CAROLINA MERCY MEDICAL CLINIC PC NPI is 1104154988. The provider is registered as an organization entity type.

The provider's business location address is:

2101 W FRANKLIN BLVD
GASTONIA, NC
ZIP 28052-338
Phone: (704) 867-8855
Fax: (704) 867-1414

The provider's authorized official is Cornelius S Okonkwo .
The authorized official title is Director and has the following contact phone number (704) 867-8855.

The CLIA number assigned to this NPI record is 34D0991958 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/7/2009 and was last updated on 2/5/2010.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	200100074	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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