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General NPI Number Information
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NPI Number | 1144288085
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Entity Type | Organization
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Legal Business Name | CAROLINA MEDICORP ENTERPRISES, INC
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 501 HICKORY BRANCH DR DBA PRIMECARE HICKORY BRANCH
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City | GREENSBORO
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State | NC
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Zip | 27409-9601
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Country | US
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Telephone | 336-878-2260
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Fax | 336-878-2277
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Provider Business Mailing Address
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Address Line | 2000 FRONTIS PLAZA BLVD STE 200 (ATTN) FORSYTH MEDICAL GROUP
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City | WINSTON SALEM
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State | NC
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Zip | 27103-5616
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Country | US
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Telephone | 336-277-2435
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Fax | 336-277-9275
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | PAUL M. BARRY
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Credential |
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Telephone | 336-774-0040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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