Provider Demographics
NPI:1093883852
Name:CAROLINA FAMILY HEALTH CENTERS, INC
Entity Type:Organization
Organization Name:CAROLINA FAMILY HEALTH CENTERS, INC
Other - Org Name:HARVEST FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-293-0013
Mailing Address - Street 1:303 GREEN ST E
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4105
Mailing Address - Country:US
Mailing Address - Phone:252-293-0013
Mailing Address - Fax:252-243-2576
Practice Address - Street 1:8250 NC 58 S
Practice Address - Street 2:
Practice Address - City:ELM CITY
Practice Address - State:NC
Practice Address - Zip Code:27822-8079
Practice Address - Country:US
Practice Address - Phone:252-443-7744
Practice Address - Fax:252-443-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344582AMedicaid
NC017HGOtherBCBS OF NC
NC344582BMedicaid
NC344582AMedicaid
NC344582CMedicaid
NC344582DMedicaid
NC344582CMedicaid