MEDICARE: CAROLINA FAMILY HEALTH CENTERS, INC.

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
1	261QF0400X	Federally Qualified Health Center (FQHC)
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy
4	3336C0002X	Clinic Pharmacy	09105	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2065494	OTHER		PK

General Provider Information

NPI Number	:	1235294497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA FAMILY HEALTH CENTERS, INC.

Provider Business Mailing Address
First Line	:	8250 NC 58 S
Second Line	:
City	:	ELM CITY
State	:	NC
Zip	:	27822-8079
Country	:	US
Telephone Number	:	252-972-4399
Fax Number	:	252-442-2950

Provider Business Practice Location Address
First Line	:	8282 NC 58 S
Second Line	:
City	:	ELM CITY
State	:	NC
Zip	:	27822-8079
Country	:	US
Telephone Number	:	252-972-4399
Fax Number	:	252-442-2950

Authorized Official
Title or Position	:	CEO
Name	:	LAURA OWENS
Credential	:	PHARMD
Telephone Number	:	252-243-9800

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	06/07/2023

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