Carolina Radiation Medicine, Pa

LBN: Carolina Radiation Medicine, Pa
Carolina Radiation Medicine, Pa is an health care organization with primary practice located at 801 W H Smith Blvd , Greenville NC 27834-3764. The organization recently has only one registered license in Ambulatory Health Care Facilities / Radiology, which is considered as the primary health care specialty. Carolina Radiation Medicine, Pa can be contacted via phone (252) 329-0025, or through Koltis, Gordon Gary via phone (252) 329-0025.

Contact Information

Primary practice address
801 W H Smith Blvd Greenville NC 27834-3764
Fax: (252) 329-0325
Website:
Authorized official contact:
Name: Koltis, Gordon Gary Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X

Profile Details

NPI number 1053315093
LBN Legal business name Carolina Radiation Medicine, Pa
DBA Doing business as
Authorized official Koltis, Gordon Gary Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 8th, 2005
Last updated Jul 18th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053315093 NPPES
North Carolina Other 118170 TRICARE
North Carolina Other 24-00059 TRICARE
North Carolina MEDICAID 89010SK TRICARE
North Carolina Other 010SK TRICARE

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