Provider Demographics
NPI:1679758759
Name:CABARRUS FAMILY MEDICINE
Entity Type:Organization
Organization Name:CABARRUS FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-721-2062
Mailing Address - Street 1:270 COPPERFIELD BLVD NE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2441
Mailing Address - Country:US
Mailing Address - Phone:704-721-2090
Mailing Address - Fax:
Practice Address - Street 1:270 COPPERFIELD BLVD NE
Practice Address - Street 2:SUITE 201
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2441
Practice Address - Country:US
Practice Address - Phone:704-721-2090
Practice Address - Fax:704-721-7424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
017KUOtherBCBS
NC89012UVMedicaid
NC89012UWMedicaid
NCCJ2206OtherRAILROAD MEDICARE
NC348937OtherMEDICARE RURAL HEALTH
NC89012UTMedicaid
NC89012UUMedicaid
NC89013T2Medicaid
NC348937AMedicaid
NC89015EGMedicaid
NC89015EGMedicaid