Provider Demographics
NPI:1265518823
Name:PHYSICIANS THERACARE, INC.
Entity type:Organization
Organization Name:PHYSICIANS THERACARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARLUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-920-0724
Mailing Address - Street 1:PO BOX 10887
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27532-0887
Mailing Address - Country:US
Mailing Address - Phone:919-735-4275
Mailing Address - Fax:
Practice Address - Street 1:1600 WAYNE MEMORIAL DR
Practice Address - Street 2:SUITE C
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2201
Practice Address - Country:US
Practice Address - Phone:919-735-4275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34782261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890136RMedicaid
NC2321468Medicare ID - Type Unspecified