Healthcare Provider Details

I. General information

NPI: 1790001154
Provider Name (Legal Business Name): CENTERS FOR WHOLE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2010
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 BRAGG BLVD STE C
FAYETTEVILLE NC
28303-4148
US

IV. Provider business mailing address

439 WESTWOOD SHOPPING CTR
FAYETTEVILLE NC
28314-1532
US

V. Phone/Fax

Practice location:
  • Phone: 910-605-6697
  • Fax: 833-340-7315
Mailing address:
  • Phone: 910-605-6697
  • Fax: 910-483-7606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number42673
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAMELA LIN HARRIS
Title or Position: OWNER
Credential: MD
Phone: 910-605-6697