Provider Demographics
NPI:1629498878
Name:MCPC-8, LLC
Entity Type:Organization
Organization Name:MCPC-8, LLC
Other - Org Name:FIRSTHEALTH CONVENIENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position: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:910-715-5413
Mailing Address - Street 1:PO BOX 843298
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-3298
Mailing Address - Country:US
Mailing Address - Phone:910-417-4100
Mailing Address - Fax:910-417-4140
Practice Address - Street 1:921 S LONG DR
Practice Address - Street 2:SUITE104
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4874
Practice Address - Country:US
Practice Address - Phone:910-417-4100
Practice Address - Fax:910-417-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty