# CAROLINAS MEDICAL ALLIANCE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134186455
- **Authorized official:** DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
- **Authorized official phone:** (615) 465-7000

## Contact information

- **Practice address:** 101 JOHN ST, LAKE CITY, SC 29560-2411
- **Practice address phone:** (843) 394-2031
- **Mailing address:** 101 JOHN ST, LAKE CITY, SC 29560-2411
- **Mailing address phone:** (843) 394-2031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/28/2006
- **Last updated:** 10/29/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP3161 | — | SC |