| Pediatric Hematology Oncology | |
|
1000 Blythe Blvd Charlotte NC 28203-5812 | |
| (704) 355-2000 | |
| Not Available |
| Full Name | Pediatric Hematology Oncology |
|---|---|
| Speciality | Clinic/center |
| Location | 1000 Blythe Blvd, Charlotte, North Carolina |
| Authorized Official Name and Position | Greg Gombar (ADMINISTRATOR) |
| Authorized Official Contact | 7043552154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Hematology Oncology Po Box 32861 Charlotte NC 28232-2861 Ph: (704) 512-6438 | Pediatric Hematology Oncology 1000 Blythe Blvd Charlotte NC 28203-5812 Ph: (704) 355-2000 |
| NPI Number | 1588700751 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 04/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588700751 | NPI | - | NPPES |
| NPA501 | Medicaid | SC | |
| 590123E | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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