Provider Demographics
NPI:1891855847
Name:HOPE FAMILY CENTER PC
Entity Type:Organization
Organization Name:HOPE FAMILY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-944-0779
Mailing Address - Street 1:210 MAGNOLIA SQUARE CT
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315
Mailing Address - Country:US
Mailing Address - Phone:910-944-0779
Mailing Address - Fax:910-944-2298
Practice Address - Street 1:210 MAGNOLIA SQUARE CT
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315
Practice Address - Country:US
Practice Address - Phone:910-944-0779
Practice Address - Fax:910-944-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36463207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911477Medicaid
7187177OtherAETNA
D7884OtherMEDCOST
11477OtherBCBS NC
FH1020290OtherFCC
1900572OtherCIGNA
FH1020290OtherFCC
NC8911477Medicaid