Organization
NCCRTEAM
Active
Other names
NCCRTEAM
Organization subpart
No
Provider details
NPI number
Authorized official
NATSHA JOHNSON (EXECUTOR)
(704) 493-1641
Entity
Organization
Contact information
Practice address
1911 SUGARBUSH DR, CHARLOTTE, NC 28214-1082
(704) 493-1641
Mailing address
1911 SUGARBUSH DR, CHARLOTTE, NC 28214-1082
(704) 493-1641
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
08/23/2022
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