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General NPI Number Information
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NPI Number | 1093062598
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Entity Type | Organization
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Legal Business Name | MOORE FREE CARE CLINIC, INC.
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 211 TRIMBLE PLANT RD STE C
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-3444
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Country | US
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Telephone | 910-246-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 211 TRIMBLE PLANT RD STE C
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-3444
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Country | US
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Telephone | 910-246-5333
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. ANTHONY PRICE
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Credential |
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Telephone | 910-246-5333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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