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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 Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for CAROLINA FAMILY MEDICINE & WELLNESS

NPI # 1912969106
LBN Legal business name CAROLINA FAMILY MEDICINE & WELLNESS
Authorized official ALISSANDRO CASTILLO - (MEDICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/04/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
NC License # 9900793
NC Medicaid 89015VY
NC Other 015VY BLUE CROSS/BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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