Organization
CAROLINA IMAGING LLC OF FAYETTEVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY K. GARDNER (SVP FINANCE AND REVENUE CYCLE)
(336) 718-2078
Entity
Organization
Contact information
Practice address
3628 CAPE CENTER DR, FAYETTEVILLE, NC 28304-4406
(910) 483-1321
(910) 323-3521
Mailing address
PO BOX 933393, ATLANTA, GA 31193-0001
(866) 659-1211
(336) 774-1751
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108T
BCBS NC
NC
01
—
153417000
DOL
NC
05
—
890108T
—
NC
01
—
P00450149
MEDICARE RAILROAD
—
Enumeration date
05/03/2006
Last updated
03/20/2024
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