Provider Demographics
NPI:1922142066
Name:PINES QUICK CARE & FAMILY MEDICINE P.A.
Entity Type:Organization
Organization Name:PINES QUICK CARE & FAMILY MEDICINE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:F
Authorized Official - Last Name:BEALE
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:910-895-0444
Mailing Address - Street 1:308 S. LAWRENCE ST.
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379
Mailing Address - Country:US
Mailing Address - Phone:910-895-0444
Mailing Address - Fax:910-895-0707
Practice Address - Street 1:308 S. LAWRENCE ST.
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379
Practice Address - Country:US
Practice Address - Phone:910-895-0444
Practice Address - Fax:910-895-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-00276261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC76258OtherMEDCOST
NC1391107001OtherCIGNA HEALTHCARE
NC89-40408Medicaid
NCFH1000295OtherFIRST CAROLINA CARE
NC40408OtherBLUE CROSS OF NC
NCFH1000295OtherFIRST CAROLINA CARE
NC89-40408Medicaid