Organization
CLEVELAND HEALTH VENTURES LLC
Active
Parent organization
CLEVELAND HEALTH VENTURES LLC
Other names
Carolinas Healthcare Urgent Care Shelby
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLEVELAND HEALTH VENTURES LLC
Authorized official
DANIEL WIENS (SENIOR VICE PRESIDENT)
(704) 355-0648
Entity
Organization
Contact information
Practice address
1010 E DIXON BLVD, SHELBY, NC 28152-6838
(980) 487-2900
(980) 487-2901
Mailing address
PO BOX 601884, CHARLOTTE, NC 28260-1884
(980) 487-2900
(980) 487-2901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5919549
—
NC
01
—
7705426
NC MEDICAID DME
NC
Enumeration date
12/13/2011
Last updated
07/05/2013
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