1457637704 NPI number — FIRSTHEALTH OF THE CAROLINAS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457637704 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:
Provider Other Organization Name Type Code:
6
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:
1457637704
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
155 MEMORIAL DR
Provider Second Line Business Mailing Address:
DIR-OUTPATIENT/REGIONAL REHABILITATION
Provider Business Mailing Address City Name:
PINEHURST
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28374-8710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-715-1656
Provider Business Mailing Address Fax Number:
910-715-1926

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
923 W 3RD ST
Provider Second Line Business Practice Location Address:
FIRSTHEALTH CENTER OF REHABILITATION-PEMBROKE
Provider Business Practice Location Address City Name:
PEMBROKE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28372-9684
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-522-2072
Provider Business Practice Location Address Fax Number:
910-522-2074
Provider Enumeration Date:
11/01/2011

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:
910-715-4473

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , 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)





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