Healthcare Provider Details
I. General information
NPI: 1548276389
Provider Name (Legal Business Name): FIRSTHEALTH OF THE CAROLINAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/01/2006
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
522 ALLEN ST SUITE 101
TROY NC
27371-2861
US
IV. Provider business mailing address
522 ALLEN ST STE 101
TROY NC
27371-2861
US
V. Phone/Fax
- Phone: 910-571-5510
- Fax: 910-571-5772
- Phone: 910-571-5510
- Fax: 910-571-5572
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 200401306 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | NC |
VIII. Authorized Official
Name:
MICKEY
FOSTER
Title or Position: CEO
Credential:
Phone: 910-715-4473