Healthcare Provider Details

I. General information

NPI: 1275586232
Provider Name (Legal Business Name): MOORE FAMILY CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 SAUNDERS ST
CARTHAGE NC
28327-9343
US

IV. Provider business mailing address

304 SAUNDERS ST
CARTHAGE NC
28327-9343
US

V. Phone/Fax

Practice location:
  • Phone: 910-947-3000
  • Fax: 910-947-6798
Mailing address:
  • Phone: 910-947-3000
  • Fax: 910-947-6798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number116644
License Number StateNC

VIII. Authorized Official

Name: DR. THOMAS LEONARD
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 910-947-3000