Provider Demographics
NPI:1356311237
Name:CAROLINA WOMEN'S HEALTH CENTER, PA
Entity Type:Organization
Organization Name:CAROLINA WOMEN'S HEALTH CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:HAMER
Authorized Official - Last Name:RUBINOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-775-2304
Mailing Address - Street 1:1140 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4161
Mailing Address - Country:US
Mailing Address - Phone:919-775-2304
Mailing Address - Fax:919-775-4020
Practice Address - Street 1:1140 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4161
Practice Address - Country:US
Practice Address - Phone:919-775-2304
Practice Address - Fax:919-775-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36747174400000X
NC9400974174400000X
NC13251174400000X
NC168176B00000X
NC129176B00000X
NC200501812207V00000X
NC61868363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Not Answered176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89012Y6Medicaid
NC02608OtherBCBS
NC02608OtherBCBS