1912997263 NPI number — FIRSTHEALTH OF THE CAROLINAS, INC.

Table of content: (NPI 1912997263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912997263 NPI number — FIRSTHEALTH OF THE CAROLINAS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRSTHEALTH OF THE CAROLINAS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FIRST HEALTH HOME CARE-RICHMOND
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912997263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
181A WESTGATE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST END
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27376-8033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-295-2211
Provider Business Mailing Address Fax Number:
910-295-8848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
925 S LONG DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKINGHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28379-4835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-997-5800
Provider Business Practice Location Address Fax Number:
910-997-4170
Provider Enumeration Date:
10/27/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FOSTER
Authorized Official First Name:
MICKEY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
910-715-1913

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HC0423 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 007AM . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 3417041 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".