Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
CAROLINA UROLOGY CENTER, PA
Active
Organization
CAROLINA UROLOGY CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY BLACK (ADMINISTRATOR)
(803) 327-1116
Entity
Organization
Contact information
Practice address
580 KINGSLEY PARK DR, SUITE 150, FORT MILL, SC 29715-6403
(803) 578-7600
(803) 431-2257
Mailing address
1780 MEDICAL PARK DR, ROCK HILL, SC 29732-1194
(803) 327-1116
(803) 327-6872
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA4307
—
SC
Enumeration date
06/16/2008
Last updated
12/02/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers