Healthcare Provider Details

I. General information

NPI: 1013195445
Provider Name (Legal Business Name): CAMPBELL'S FAMILY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 HUGGINS ST
STATESVILLE NC
28677-5015
US

IV. Provider business mailing address

1415 HUGGINS ST
STATESVILLE NC
28677-5015
US

V. Phone/Fax

Practice location:
  • Phone: 704-872-1488
  • Fax:
Mailing address:
  • Phone: 704-872-1488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License NumberFCL-O49-001
License Number StateNC

VIII. Authorized Official

Name: MS. MARGARET CAMPBELL
Title or Position: ADMINISTRATOR
Credential:
Phone: 704-872-1488