Provider Demographics
NPI:1386607505
Name:CENTRAL CAROLINA WOMEN'S CENTER, PA
Entity type:Organization
Organization Name:CENTRAL CAROLINA WOMEN'S CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PRYCE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MHA
Authorized Official - Phone:336-626-6371
Mailing Address - Street 1:237 N FAYETTEVILLE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5572
Mailing Address - Country:US
Mailing Address - Phone:336-626-6371
Mailing Address - Fax:336-629-0436
Practice Address - Street 1:237 N FAYETTEVILLE ST
Practice Address - Street 2:SUITE A
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5572
Practice Address - Country:US
Practice Address - Phone:336-626-6371
Practice Address - Fax:336-629-0436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890114BMedicaid
NC0159YOtherBCBS GROUP NUMBER
NC890114BMedicaid