Provider Demographics
NPI:1184811572
Name:CAROLINA FAMILY HEALTH CENTERS INC
Entity type:Organization
Organization Name:CAROLINA FAMILY HEALTH CENTERS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:PHRMD
Authorized Official - Phone:252-243-9800
Mailing Address - Street 1:162 NC HIGHWAY 33 E
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-8582
Mailing Address - Country:US
Mailing Address - Phone:252-824-3800
Mailing Address - Fax:252-824-3810
Practice Address - Street 1:162 NC HIGHWAY 33 E
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-8582
Practice Address - Country:US
Practice Address - Phone:252-824-3800
Practice Address - Fax:252-824-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QF0400X, 333600000X, 3336C0003X
NC099113336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344526BMedicaid
2066551OtherPK