Coastal Carolinas Integrated Medicine Pa
LBN: Coastal Carolinas Integrated Medicine Pa
Coastal Carolinas Integrated Medicine Pa is an health care organization with primary practice located at 10 Doctors Cir Suite 2, Supply NC 28462-4089. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as the primary health care specialty.
Coastal Carolinas Integrated Medicine Pa can be contacted via phone (910) 755-6060, or through Willeford, Kenneth Lee via phone (910) 755-6060.
Contact Information
Primary practice address
10 Doctors Cir Suite 2
Supply NC 28462-4089
Phone: (910) 755-6060
Fax: (910) 755-6061
Website:
Authorized official contact:
Name: Willeford, Kenneth Lee Doctor of Medicine (MD)
Phone: (910) 755-6060
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | 36621 | North Carolina |
Profile Details
| NPI number | 1649304239 |
|---|---|
| LBN Legal business name | Coastal Carolinas Integrated Medicine Pa |
| DBA Doing business as | |
| Authorized official | Willeford, Kenneth Lee Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 15th, 2007 |
| Last updated | Aug 7th, 2013 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649304239 | NPPES |
| North Carolina | Other | 016UX | BCBS |
| North Carolina | MEDICAID | 8987642 | BCBS |
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