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Organization

CHARLENE LYDIA BLAINE

Active
Other names
Respi-Test Independent Lab
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CHARLENE LYDIA BLAINE CRT, RCP (PRESIDENT)
(919) 359-9920
Entity
Organization

Contact information

Practice address
11048 CLEVELAND ROAD, SUITE 101-102, GARNER, NC 27529
(919) 359-9920
(919) 359-2520
Mailing address
11048 CLEVELAND ROAD, SUITE 101-102, GARNER, NC 27529
(919) 359-9920
(919) 359-2520

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
9500533
NC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
9500533
NC
2278P1004X
Pulmonary Diagnostics Certified Respiratory Therapist
A-4125
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
017PY
BCBSNC
NC
01
3500316
UNITED HEALTHCARE
NC
01
37119
PARTNERS
NC
01
429202
WELLPATH
NC
05
5902258
NC
Enumeration date
10/31/2005
Last updated
06/16/2008
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