MEDICARE: CHILDREN'S HEALTH OF CAROLINA, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1144284548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S HEALTH OF CAROLINA, PA

Provider Business Mailing Address
First Line	:	4305 FAYETTEVILLE RD STE A
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-2623
Country	:	US
Telephone Number	:	910-739-3318
Fax Number	:	910-225-4255

Provider Business Practice Location Address
First Line	:	1940 CLUB POND RD
Second Line	:
City	:	RAEFORD
State	:	NC
Zip	:	28376-8691
Country	:	US
Telephone Number	:	910-739-3319
Fax Number	:	910-875-8680

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	LAURA FREEMAN SEALY
Credential	:
Telephone Number	:	910-738-8060

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	03/25/2026

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