1114116431 NPI number — UWHARRIE FAMILY HEALTH CARE

Table of content: (NPI 1114116431)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114116431 NPI number — UWHARRIE FAMILY HEALTH CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UWHARRIE FAMILY HEALTH CARE
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:
DR. DEBORAH S. MCROBERTS
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:
1114116431
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1630 NC HIGHWAY 24 27 W
Provider Second Line Business Mailing Address:
P.O.BOX 429
Provider Business Mailing Address City Name:
BISCOE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27209-8068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-220-1661
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1630 NC HIGHWAY 24 27 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BISCOE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27209-8068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-220-1661
Provider Business Practice Location Address Fax Number:
910-428-5225
Provider Enumeration Date:
10/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCROBERTS
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
910-220-1661

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  32404 , 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: 8958249 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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