| Carolina Medicorp Enterprises Inc | |
|
10322 Bristow Center Dr Bristow VA 20136-2201 | |
| (571) 284-4245 | |
| Not Available |
| Full Name | Carolina Medicorp Enterprises Inc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 10322 Bristow Center Dr, Bristow, Virginia |
| Authorized Official Name and Position | Geoffery K Gardner (VP OF FINANCE) |
| Authorized Official Contact | 5712844245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Medicorp Enterprises Inc Po Box 751803 Charlotte NC 28275-1803 Ph: (571) 284-4245 | Carolina Medicorp Enterprises Inc 10322 Bristow Center Dr Bristow VA 20136-2201 Ph: (571) 284-4245 |
| NPI Number | 1689045239 |
|---|---|
| Provider Enumeration Date | 10/08/2015 |
| Last Update Date | 10/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689045239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207P00000X | Emergency Medicine | (* (Not Available)) | Primary |
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