Healthcare Provider Details

I. General information

NPI: 1184792103
Provider Name (Legal Business Name): CAROLINA FAMILY HEALTH CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 GREEN ST E
WILSON NC
27893-4105
US

IV. Provider business mailing address

303 GREEN ST E
WILSON NC
27893-4105
US

V. Phone/Fax

Practice location:
  • Phone: 252-243-9800
  • Fax: 252-243-9888
Mailing address:
  • Phone: 252-293-0013
  • Fax: 252-243-2576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURA OWENS
Title or Position: CEO
Credential:
Phone: 252-293-0013