COASTAL CAROLINA FAMILY PRACTICE PA NPI 1326031485

NPI Information

NPI: 1326031485
Provider Name: COASTAL CAROLINA FAMILY PRACTICE PA
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 34D0938057

Address:
600 S CHURCH ST
HERTFORD, NC
ZIP 27944
Phone: (252) 426-5711
Get Directions

COASTAL CAROLINA FAMILY PRACTICE PA is a family medicine in Hertford, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. COASTAL CAROLINA FAMILY PRACTICE PA NPI is 1326031485. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

600 S CHURCH ST
HERTFORD, NC
ZIP 27944-205
Phone: (252) 426-5711
Fax: (252) 426-1999

The provider's authorized official is Chris A Lane .
The authorized official title is Medical Adm and has the following contact phone number (252) 426-5711.

The CLIA number assigned to this NPI record is 34D0938057 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 8/24/2005 and was last updated on 7/9/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		40834	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0222L	OTHER	NORTH CAROLINA	BCBS
2	2322485	MEDICARE PIN	NORTH CAROLINA
3	044647	OTHER		TRIGON
4	=========	OTHER		TRICARE
5	890222L	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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