Provider Demographics
NPI:1336678663
Name:FIRSTHEALTH OF THE CAROLINAS, INC.
Entity Type:Organization
Organization Name:FIRSTHEALTH OF THE CAROLINAS, INC.
Other - Org Name:MOORE REGIONAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-1093
Mailing Address - Street 1:PO BOX 3000
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-3000
Mailing Address - Country:US
Mailing Address - Phone:910-715-1064
Mailing Address - Fax:910-715-1070
Practice Address - Street 1:155 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8710
Practice Address - Country:US
Practice Address - Phone:910-715-1064
Practice Address - Fax:910-715-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
NC060253336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2169434OtherPK