Healthcare Provider Details

I. General information

NPI: 1396770756
Provider Name (Legal Business Name): FAMILY CARE CENTER , P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1668 N C HIGHWAY 16 SOUTH
TAYLORSVILLE NC
28681
US

IV. Provider business mailing address

1668 N C HIGHWAY 16 SOUTH
TAYLORSVILLE NC
28681
US

V. Phone/Fax

Practice location:
  • Phone: 828-632-9736
  • Fax: 828-632-9544
Mailing address:
  • Phone: 828-632-9736
  • Fax: 828-632-9544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateNC

VIII. Authorized Official

Name: MRS. KELLIE D DANCY
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 828-632-9736