Organization
CAROLINA MEDICORP ENTERPRISES, INC
Active
Other names
Novant Health Urgent Care & Occupational Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY GARDNER (VP FINANCE)
(336) 878-2260
Entity
Organization
Contact information
Practice address
501 HICKORY BRANCH DR, GREENSBORO, NC 27409-9601
(336) 878-2260
(336) 878-2277
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(704) 716-4820
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126Q
BCBS NC
NC
05
—
89012M
—
NC
01
—
CI3211
RAILROAD MEDICARE
NC
Enumeration date
05/02/2006
Last updated
06/05/2019
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