Organization
CAROLINA DIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL IBERGER (EVP-CFO)
(978) 536-6105
Entity
Organization
Contact information
Practice address
119 KANDEMOR LN, ROCKY MOUNT, NC 27804-3212
(252) 937-6692
(252) 937-6697
Mailing address
200 CORPORATE PL, PEABODY, MA 01960-3840
(978) 536-7400
(978) 535-9757
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12467
BCBS PIN
NC
05
—
89013EP
—
NC
01
—
P00391188
RR MEDICARE
NC
Enumeration date
05/17/2006
Last updated
06/27/2014
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