Organization
CAROLINAS MEDICAL ALLIANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
1594 FREEDOM BLVD, STE 202, FLORENCE, SC 29505-6046
(843) 664-9696
Mailing address
1594 FREEDOM BLVD, STE 202, FLORENCE, SC 29505-6046
(843) 664-9696
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN2547
MEDICARE RAILROAD
SC
05
—
GP2626
—
SC
Enumeration date
05/10/2006
Last updated
01/02/2008
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