Organization
CAROLINA KIDNEY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY L MCCASKILL (PERSONNEL MANAGER)
(336) 379-9708
Entity
Organization
Contact information
Practice address
212 FOUST STREET, CAROLINA KIDNEY ASSOCIATES PA, ASHEBORO, NC 27203-5404
(336) 626-0443
(336) 379-8714
Mailing address
309 NEW STREET, GREENSBORO, NC 27405-3654
(336) 379-9708
(336) 379-8714
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01598
CKA'S BCBS GP PROV #
NC
05
—
8901598
—
NC
01
—
CD6638
CKA'S RRM GP PROV #
NC
Enumeration date
05/25/2006
Last updated
08/17/2018
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