Organization
CAROLINA MEDICORP ENTERPRISES INC
Active
Other names
Novant Health Express Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY K GARDNER (VP FINANCE)
(704) 384-7603
Entity
Organization
Contact information
Practice address
480 FLETCHER DR, SUITE 3, WARRENTON, VA 20186-2185
(704) 384-7603
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(704) 384-7840
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164815262
—
VA
Enumeration date
03/13/2015
Last updated
08/19/2015
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