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Organization
CAROMONT HEALTH SERVICES, INC.
Active
Organization
CAROMONT HEALTH SERVICES, INC.
Active
Other names
CaroMont Specialty Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID O'CONNOR (VP CHIEF FINANCIAL OFFICER)
(704) 834-2049
Entity
Organization
Contact information
Practice address
2511 COURT DR, GASTONIA, NC 28054-2140
(704) 671-5600
Mailing address
2511 COURT DR, GASTONIA, NC 28054-2140
(704) 671-5600
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AS0037
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00632
BLUE CROSS
NC
01
—
0585105
AETNA
NC
01
—
0734076003
CIGNA
NC
01
—
312280
FEDERAL BLACK LUNG
NC
05
—
3409852
—
NC
01
—
3697
WELLPATH
NC
01
—
371708500
DEPARTMENT OF LABOR
NC
01
—
5040770
UNITED HEALTHCARE
NC
05
—
ASC002
—
SC
Enumeration date
10/17/2005
Last updated
08/29/2007
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