Coastal Carolina Family Practice Pa is a medicare enrolled primary clinic (Family Medicine) in Hertford, North Carolina. The current practice location for Coastal Carolina Family Practice Pa is 600 S Church St, Hertford, North Carolina. For appointments, you can reach them via phone at
(252) 426-5711. The mailing address for Coastal Carolina Family Practice Pa is Po Box 650, Hertford, North Carolina and phone number is (252) 426-5711.
Coastal Carolina Family Practice Pa is licensed to practice in North Carolina (license number 40834). The clinic also participates in the medicare program and its
NPI number is 1326031485. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(252) 426-5711.
Primary Care Clinic Profile
| Full Name | Coastal Carolina Family Practice Pa |
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| Speciality | Family Medicine |
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| Location | 600 S Church St, Hertford, North Carolina |
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| Authorized Official Name and Position | Chris A Lane (MEDICAL ADM) |
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| Authorized Official Contact | 2524265711 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Coastal Carolina Family Practice Pa
Po Box 650
Hertford
NC 27944-0650
Ph: (252) 426-5711 | Coastal Carolina Family Practice Pa
600 S Church St
Hertford
NC 27944-1205
Ph: (252) 426-5711 |
NPI Details:
| NPI Number | 1326031485 |
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| Provider Enumeration Date | 08/24/2005 |
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| Last Update Date | 07/09/2010 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 6901985688 |
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| Medicare Enrollment ID | O20080506000716 |
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Medical Identifiers
Medical identifiers for Coastal Carolina Family Practice Pa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1326031485 | NPI | - | NPPES |
| 0222L | Other | NC | BCBS |
| 044647 | Other | | TRIGON |
| 890222L | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 40834 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Coastal Carolina Family Practice Pa acts as a billing entity for following providers:
| Provider Name | Robert E Lane |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1023001500
PECOS PAC ID: 7911086699
Enrollment ID: I20080506000707 |
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