Provider Demographics
NPI:1750688305
Name:LUMBERTON FAMILY URGENT CARE CENTER
Entity Type:Organization
Organization Name:LUMBERTON FAMILY URGENT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARBUS
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOCKLEAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:PA-C
Authorized Official - Phone:910-739-0272
Mailing Address - Street 1:309 N ROBERTS AVE
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-5383
Mailing Address - Country:US
Mailing Address - Phone:910-739-0272
Mailing Address - Fax:910-739-0375
Practice Address - Street 1:309 N ROBERTS AVE
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-5383
Practice Address - Country:US
Practice Address - Phone:910-739-0272
Practice Address - Fax:910-739-0375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102608363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty