Organization
MERCY HOSPITAL, INC.
Active
Other names
CMC - Pineville CRNA
Organization subpart
No
Provider details
NPI number
Authorized official
GREG GOMBAR (ADMINISTRATOR)
(704) 355-2154
Entity
Organization
Contact information
Practice address
10628 PARK RD, CHARLOTTE, NC 28210-8407
(704) 543-2025
(704) 543-2010
Mailing address
PO BOX 32861, CHARLOTTE, NC 28232-2861
(704) 512-6438
(704) 512-6485
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8000172
—
NC
Enumeration date
11/22/2006
Last updated
04/19/2011
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