Healthcare Provider Details

I. General information

NPI: 1548539646
Provider Name (Legal Business Name): FIRSTHEALTH OF THE CAROLINAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2011
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MEMORIAL DR
PINEHURST NC
28374-8710
US

IV. Provider business mailing address

PO BOX 3000
PINEHURST NC
28374-3000
US

V. Phone/Fax

Practice location:
  • Phone: 910-715-4250
  • Fax: 910-715-4255
Mailing address:
  • Phone: 910-715-4250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number11169
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DONNA MARQUIS-HENKE
Title or Position: AMBULATORY PHARMACY MANAGER
Credential:
Phone: 910-715-6248