Provider Demographics
NPI:1457637704
Name:FIRSTHEALTH OF THE CAROLINAS, INC.
Entity Type:Organization
Organization Name:FIRSTHEALTH OF THE CAROLINAS, INC.
Other - Org Name:FIRSTHEALTH CENTER FOR REHABILITATION - PEMBROKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEJACO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-1913
Mailing Address - Street 1:155 MEMORIAL DR
Mailing Address - Street 2:DIR-OUTPATIENT/REGIONAL REHABILITATION
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8710
Mailing Address - Country:US
Mailing Address - Phone:910-715-1656
Mailing Address - Fax:910-715-1926
Practice Address - Street 1:923 W 3RD ST
Practice Address - Street 2:FIRSTHEALTH CENTER OF REHABILITATION-PEMBROKE
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-9684
Practice Address - Country:US
Practice Address - Phone:910-522-2072
Practice Address - Fax:910-522-2074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy