Provider Demographics
NPI:1376892539
Name:MCPC-5, LLC
Entity Type:Organization
Organization Name:MCPC-5, LLC
Other - Org Name:FIRSTHEALTH CARDIOLOGY SERVICES-ROCKINGHAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:SEALS
Authorized Official - Last Name:DEJACO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-1913
Mailing Address - Street 1:106 PHYSICIANS PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-5204
Mailing Address - Country:US
Mailing Address - Phone:910-895-7227
Mailing Address - Fax:910-895-7089
Practice Address - Street 1:106 PHYSICIANS PARK DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-5204
Practice Address - Country:US
Practice Address - Phone:910-895-7227
Practice Address - Fax:910-895-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty