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)

General Provider Information

NPI Number	:	1417427642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA FAMILY HEALTH CENTERS, INC

Provider Business Mailing Address
First Line	:	303 GREEN ST E
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-4105
Country	:	US
Telephone Number	:	252-293-0013
Fax Number	:	252-243-2576

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	:	252-443-7764
Fax Number	:	252-443-7611

Authorized Official
Title or Position	:	CEO
Name	:	LAURA OWENS
Credential	:
Telephone Number	:	252-293-0013

Provider Enumeration Date	:	11/30/2018
Last Update Date	:	10/26/2023

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