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General NPI Number Information
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NPI Number | 1285658021
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Entity Type | Organization
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Legal Business Name | PEMBROKE MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 102 SOUTH MAIN STREET
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City | PEMBROKE
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State | NC
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Zip | 28372
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Country | US
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Telephone | 910-521-0510
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Fax | 910-521-5582
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Provider Business Mailing Address
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Address Line | PO BOX 3609 102 SOUTH MAIN STREET
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City | PEMBROKE
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State | NC
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Zip | 28372-3609
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Country | US
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Telephone | 910-521-0510
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Fax | 910-521-5582
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Authorized Official
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Title or Position | MD PHYSICIAN
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Name | MR. FRANK WORIAX
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Credential | MD
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Telephone | 910-521-0510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 21384
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License Number State | NC
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