Provider Demographics
NPI:1346338159
Name:CAROLINA FAMILY AND URGENT CARE
Entity Type:Organization
Organization Name:CAROLINA FAMILY AND URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-618-0026
Mailing Address - Street 1:4380 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2677
Mailing Address - Country:US
Mailing Address - Phone:910-618-0026
Mailing Address - Fax:910-618-1746
Practice Address - Street 1:4380 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2677
Practice Address - Country:US
Practice Address - Phone:910-618-0026
Practice Address - Fax:910-618-1746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89013ANMedicaid
NC89013ANMedicaid
NCG83568Medicare UPIN