Organization
CAROLINAS MEDICAL CENTER
Active
Other names
Atrium Health Pharmacy Kenilworth
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY A CLARK (CFO)
(336) 716-5099
Entity
Organization
Contact information
Practice address
1225 HARDING PL STE 1400, CHARLOTTE, NC 28204-2826
(704) 468-3310
(704) 468-3311
Mailing address
PO BOX 604357, CHARLOTTE, NC 28260-4357
(704) 512-7637
(704) 512-7630
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0607259
—
NC
01
—
2070086
PK
—
05
—
7N5200
—
SC
Enumeration date
08/23/2006
Last updated
09/26/2025
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