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NPI Code Detail

MEDICARE: COLEMAN CHILD AND FAMILY SERVICES, P.A.

MEDICARE: COLEMAN CHILD AND FAMILY SERVICES, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency2808NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033390588
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLEMAN CHILD AND FAMILY SERVICES, P.A.
Provider Business Mailing Address
First Line : 1907 S 17TH ST STE 1
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-6680
Country : US
Telephone Number : 910-343-8424
Fax Number : 910-343-6989
Provider Business Practice Location Address
First Line : 1907 S 17TH ST STE 1
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-6680
Country : US
Telephone Number : 910-343-8424
Fax Number : 910-343-6989
Authorized Official
Title or Position : PRESIDENT
Name : MRS. JENNIFER KING COLEMAN
Credential : PH.D.
Telephone Number : 910-343-8424
Provider Enumeration Date : 11/26/2007
Last Update Date : 11/26/2007

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