Provider Demographics
NPI:1285884833
Name:CAROLINA PRIMARY CARE AND WOMEN'S HEALTH, PA
Entity type:Organization
Organization Name:CAROLINA PRIMARY CARE AND WOMEN'S HEALTH, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGADAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-297-0348
Mailing Address - Street 1:101 LATTNER CT STE 100
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-9584
Mailing Address - Country:US
Mailing Address - Phone:919-297-0348
Mailing Address - Fax:919-297-0349
Practice Address - Street 1:101 LATTNER COURT
Practice Address - Street 2:SUITE 100
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6843
Practice Address - Country:US
Practice Address - Phone:919-297-0348
Practice Address - Fax:919-297-0349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-01007261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2074179BMedicare PIN