Provider Demographics
NPI:1275586232
Name:MOORE FAMILY CARE PA
Entity Type:Organization
Organization Name:MOORE FAMILY CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-947-3000
Mailing Address - Street 1:304 SAUNDERS ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NC
Mailing Address - Zip Code:28327-9343
Mailing Address - Country:US
Mailing Address - Phone:910-947-3000
Mailing Address - Fax:910-947-6798
Practice Address - Street 1:304 SAUNDERS ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NC
Practice Address - Zip Code:28327-9343
Practice Address - Country:US
Practice Address - Phone:910-947-3000
Practice Address - Fax:910-947-6798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC116644261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC014UMOtherBLUE CROSS BLUE SHIELD NC
NC89014UPMedicaid
NC014UPOtherBCBS OF NC
NC89014UMMedicaid
NC89014UPMedicaid