| Carolina Coast Primary Medicine | |
|
275 N Nc 24 & 50 Hwy Kenansville NC 28349-0148 | |
| (910) 296-1087 | |
| (910) 296-1086 |
| Full Name | Carolina Coast Primary Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 275 N Nc 24 & 50 Hwy, Kenansville, North Carolina |
| Authorized Official Name and Position | Bertha1 Taylor- Miller (MANAGER) |
| Authorized Official Contact | 9102961087 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Coast Primary Medicine Po Box 148 Kenansville NC 28349-0148 Ph: (910) 296-1087 | Carolina Coast Primary Medicine 275 N Nc 24 & 50 Hwy Kenansville NC 28349-0148 Ph: (910) 296-1087 |
| NPI Number | 1669401964 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 11/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669401964 | NPI | - | NPPES |
| 11515 | Other | NC | BCBS |
| 5900323 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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