Organization
CMC NORTHEAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG GOMBAR (ADMINISTRATOR)
(704) 355-2154
Entity
Organization
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 783-3000
Mailing address
PO BOX 669347, CHARLOTTE, NC 28266-9347
(704) 512-6438
(704) 512-6485
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408554
—
NC
Enumeration date
05/11/2007
Last updated
04/20/2011
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