Church Family Medicine, PC

Organization Active NPI Family Medicine Physician · Supply, NC

NPI 1053628065 · NPPES record last updated Sep 13, 2010

Key facts

NPI
1053628065
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
200701334 (NC)
Legal business name
CHURCH FAMILY MEDICINE, PC
Practice address
20 Medical Campus Dr
Suite 203
Supply, NC 28462-4096
Phone
(910) 755-7181
Fax
(910) 755-7194
NPI assigned
Sep 13, 2010
Organization subpart
No

Authorized official

Name
Miss Lori A Church, MD
Title
Owner
Phone
(910) 755-7181

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 200701334 NC Yes

Addresses

Primary practice location

20 Medical Campus Dr
Suite 203
Supply, NC 28462-4096

Mailing address

20 Medical Campus Dr
Suite 203
Supply, NC 28462-4096
Phone (910) 755-7181

Other providers in Supply, NC

All providers in Supply, NC · Family Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.