Provider Demographics
NPI:1922414754
Name:CAROLINA COMPREHENSIVE HEALTH
Entity Type:Organization
Organization Name:CAROLINA COMPREHENSIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-457-9564
Mailing Address - Street 1:4654 LONG BEACH RD SE
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-8799
Mailing Address - Country:US
Mailing Address - Phone:910-457-9564
Mailing Address - Fax:910-457-6744
Practice Address - Street 1:4654 LONG BEACH RD SE
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-8799
Practice Address - Country:US
Practice Address - Phone:910-457-9564
Practice Address - Fax:910-457-6744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04910261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care