Basic Information
| Provider Information | |||||||||
| NPI: | 1457637704 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FIRSTHEALTH OF THE CAROLINAS, INC. | ||||||||
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| OtherOrganizationName: | FIRSTHEALTH CENTER FOR REHABILITATION - PEMBROKE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 MEMORIAL DR | ||||||||
| Address2: | DIR-OUTPATIENT/REGIONAL REHABILITATION | ||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283748710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107151656 | ||||||||
| FaxNumber: | 9107151926 | ||||||||
| Practice Location | |||||||||
| Address1: | 923 W 3RD ST | ||||||||
| Address2: | FIRSTHEALTH CENTER OF REHABILITATION-PEMBROKE | ||||||||
| City: | PEMBROKE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283729684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9105222072 | ||||||||
| FaxNumber: | 9105222074 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2011 | ||||||||
| LastUpdateDate: | 11/01/2011 | ||||||||
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| AuthorizedOfficialLastName: | DEJACO | ||||||||
| AuthorizedOfficialFirstName: | LYNN | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | SR VP/CFO | ||||||||
| AuthorizedOfficialTelephone: | 9107151913 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | NC | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.