National Provider Identifier Database

CAROLINA FAMILY MEDICINE WELLNESS
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

CAROLINA FAMILY MEDICINE & WELLNESS
478 WILLIAMSON RD.
SUITE B
MOORESVILLE, NC27117-9109
Phone: 704-662-3627
Fax: 704-662-3229
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for CAROLINA FAMILY MEDICINE & WELLNESS

NPI Number 1912969106
Legal business name
LBN
CAROLINA FAMILY MEDICINE & WELLNESS
Authorized official ALISSANDRO CASTILLO - (MEDICAL DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 04/04/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • NC License #: 9900793
  • NC Medicaid: 89015VY
  • NC Other: 015VY BLUE CROSS/BLUE SHIELD

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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