Organization
CAROMONT HEALTH SERVICES, INC.
Active
Other names
CaroMont Specialty Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID O'CONNOR (VP CHIEF FINANCIAL OFFICER)
(704) 834-2049
Entity
Organization
Contact information
Practice address
2511 COURT DR, GASTONIA, NC 28054-2140
(704) 671-5600
Mailing address
2511 COURT DR, GASTONIA, NC 28054-2140
(704) 671-5600
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AS0037
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00632
BLUE CROSS
NC
01
—
0585105
AETNA
NC
01
—
0734076003
CIGNA
NC
01
—
312280
FEDERAL BLACK LUNG
NC
05
—
3409852
—
NC
01
—
3697
WELLPATH
NC
01
—
371708500
DEPARTMENT OF LABOR
NC
01
—
5040770
UNITED HEALTHCARE
NC
05
—
ASC002
—
SC
Enumeration date
10/17/2005
Last updated
08/29/2007
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