Organization
OMNIMED LLC
Active
Other names
Arrowood Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA BURNS (MARKETING DIRECTOR)
(803) 329-3136
Entity
Organization
Contact information
Practice address
9720 S TRYON ST, CHARLOTTE, NC 28273-6578
(704) 588-7362
(704) 588-9127
Mailing address
9720 S TRYON ST, CHARLOTTE, NC 28273-6578
(704) 588-7362
(704) 588-9127
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
—
—
225100000X
Physical Therapist
—
—
247100000X
Radiologic Technologist
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015V0
BLUE CROSS BLUE SHIELD NC
NC
Enumeration date
10/05/2006
Last updated
04/29/2010
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