Fayetteville Family Extended Care

LBN: Fayetteville Family Extended Care
Fayetteville Family Extended Care is an health care organization with primary practice located at 1307 Avon St , Fayetteville NC 28304-4423. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Fayetteville Family Extended Care can be contacted via phone (910) 323-1718, or through Kugler, Alice M via phone (910) 323-1718.

Contact Information

Primary practice address
1307 Avon St Fayetteville NC 28304-4423
Fax: (910) 323-5701
Website:
Authorized official contact:
Name: Kugler, Alice M

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X North Carolina

Profile Details

NPI number 1710977681
LBN Legal business name Fayetteville Family Extended Care
DBA Doing business as
Authorized official Kugler, Alice M
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2005
Last updated Apr 18th, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710977681 NPPES
North Carolina MEDICAID 89015CY
North Carolina Other 015CY

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