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General NPI Number Information
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NPI Number | 1922414754
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Entity Type | Organization
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Legal Business Name | CAROLINA COMPREHENSIVE HEALTH
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 4654 LONG BEACH RD SE
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City | SOUTHPORT
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State | NC
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Zip | 28461-8799
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Country | US
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Telephone | 910-457-9564
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Fax | 910-457-6744
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Provider Business Mailing Address
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Address Line | 4654 LONG BEACH RD SE
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City | SOUTHPORT
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State | NC
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Zip | 28461-8799
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Country | US
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Telephone | 910-457-9564
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Fax | 910-457-6744
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | DEBBIE EVANS
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Credential |
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Telephone | 910-457-9564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 0010-04910
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License Number State | NC
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