Provider Demographics
NPI:1467679712
Name:CAROLINA URGENT & FAMILY CARE P.A.
Entity Type:Organization
Organization Name:CAROLINA URGENT & FAMILY CARE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WINN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:910-630-5000
Mailing Address - Street 1:5511 RAEFORD RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2057
Mailing Address - Country:US
Mailing Address - Phone:910-630-5000
Mailing Address - Fax:910-424-6767
Practice Address - Street 1:5511 RAEFORD RD
Practice Address - Street 2:SUITE 150
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2057
Practice Address - Country:US
Practice Address - Phone:910-630-5000
Practice Address - Fax:910-424-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5919517Medicaid
NC5919517Medicaid