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Organization

CMC-NORTHEAST, INC.

Active
Parent organization
CMC-NORTHEAST, INC.
Other names
Rocky River Pediatrics
Organization subpart
Yes

Provider details

NPI number
Legal business name
CMC-NORTHEAST, INC.
Authorized official
FRIEDA M LOWDER (SR. VICE PRESIDENT)
(704) 403-4146
Entity
Organization

Contact information

Practice address
5427 HIGHWAY 49 S, ROCKY RIVER PEDIATRICS, HARRISBURG, NC 28075-7408
(704) 455-5565
(704) 455-6225
Mailing address
5427 HIGHWAY 49 S, HARRISBURG, NC 28075-7408
(704) 455-5565
(704) 455-6225

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5906981
NC
01
DF8926
RAILROAD MEDICARE PTAN
NC
Enumeration date
07/17/2009
Last updated
06/01/2010
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