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General NPI Number Information
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NPI Number | 1790220408
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL PAIN CENTER, PLLC
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Dates
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Enumeration Date | 01/04/2017
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 4320 FAYETTEVILLE RD SUITE A
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City | LUMBERTON
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State | NC
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Zip | 28358-2706
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Country | US
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Telephone | 910-738-9599
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Fax | 910-738-9549
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Provider Business Mailing Address
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Address Line | PO BOX 931038
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City | ATLANTA
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State | GA
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Zip | 31193-1038
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RCM MANAGER
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Name | SHANEKA TINCH
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Credential |
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Telephone | 469-458-9222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 200100673
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License Number State | NC
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