| Carolina Primary Care, P.a. | |
|
6011 Fayetteville Rd Suite 104a Durham NC 27713-6248 | |
| (919) 405-2100 | |
| (919) 806-2004 |
| Full Name | Carolina Primary Care, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 6011 Fayetteville Rd, Durham, North Carolina |
| Authorized Official Name and Position | Anelia P Rose (PHYSICIAN OWNER) |
| Authorized Official Contact | 9194052100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Primary Care, P.a. 6011 Fayetteville Rd Suite 104a Durham NC 27713-6248 Ph: (919) 405-2100 | Carolina Primary Care, P.a. 6011 Fayetteville Rd Suite 104a Durham NC 27713-6248 Ph: (919) 405-2100 |
| NPI Number | 1275688780 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 07/12/2007 |
| Medicare PECOS PAC ID | 4082628870 |
|---|---|
| Medicare Enrollment ID | O20060201000055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275688780 | NPI | - | NPPES |
| 89014KN | Medicaid | NC | |
| 014KN | Other | NC | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 200000934 (North Carolina) | Primary |
| Provider Name | Anelia P Rose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609848928 PECOS PAC ID: 3072527860 Enrollment ID: I20111219000094 |
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