Basic Information
| Provider Information | |||||||||
| NPI: | 1902359896 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMERGEORTHO, PA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RIANGLE ORTHOPAEDIC ASSOCIATES, PA | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 LIVINGSTON ST | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282588800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 129 MCDOWELL ST | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282588800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2016 | ||||||||
| LastUpdateDate: | 06/13/2017 | ||||||||
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| AuthorizedOfficialLastName: | HOWARD | ||||||||
| AuthorizedOfficialFirstName: | PAULA | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8282817128 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MBA, RHIT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 38818 | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0401990033 | 01 | NC | PALMETTO GBA | OTHER |