Provider Demographics
NPI:1992094619
Name:FIRSTHEALTH OF THE CAROLINAS, INC.
Entity type:Organization
Organization Name:FIRSTHEALTH OF THE CAROLINAS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEJACO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-2261
Mailing Address - Street 1:921 S LONG DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-4874
Mailing Address - Country:US
Mailing Address - Phone:910-417-3540
Mailing Address - Fax:910-715-3542
Practice Address - Street 1:921 S LONG DR
Practice Address - Street 2:SUITE 208
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4874
Practice Address - Country:US
Practice Address - Phone:910-417-3540
Practice Address - Fax:910-715-3542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3566231H00000X
NC826237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty