Healthcare Provider Details

I. General information

NPI: 1316809502
Provider Name (Legal Business Name): CHILDREN'S HEALTH OF CAROLINA, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 LIBERTY HILL RD
LUMBERTON NC
28358-2442
US

IV. Provider business mailing address

4305 FAYETTEVILLE RD STE A
LUMBERTON NC
28358-2623
US

V. Phone/Fax

Practice location:
  • Phone: 910-739-3318
  • Fax:
Mailing address:
  • Phone: 910-739-3318
  • Fax: 910-225-4255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA F SEALY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 910-739-3318