Provider Demographics
NPI:1215597844
Name:COLUMBUS FAMILY MEDICAL PA
Entity Type:Organization
Organization Name:COLUMBUS FAMILY MEDICAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:STEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-642-9800
Mailing Address - Street 1:PO BOX 859
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-0859
Mailing Address - Country:US
Mailing Address - Phone:910-754-7607
Mailing Address - Fax:
Practice Address - Street 1:712 VILLAGE RD SW STE 104
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-3449
Practice Address - Country:US
Practice Address - Phone:910-754-7607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBUS FAMILY MEDICAL, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care