Pembroke Medical Center, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21384 Issued in NC

Legal business name

PEMBROKE MEDICAL CENTER, INC.

Practice address

102 South Main Street
Pembroke, NC 28372

Phone

(910) 521-0510

Fax

(910) 521-5582

NPI assigned

Jul 26, 2006

Last updated

Dec 3, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Frank Woriax, MD

Title

MD Physician

Phone

(910) 521-0510

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1285658021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3609",
            "address_2": "102 SOUTH MAIN STREET",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283723609",
            "telephone_number": "910-521-0510",
            "fax_number": "910-521-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SOUTH MAIN STREET",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "28372",
            "telephone_number": "910-521-0510",
            "fax_number": "910-521-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBROKE MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "WORIAX",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "MD PHYSICIAN",
        "authorized_official_telephone_number": "910-521-0510",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "21384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890135A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pembroke Drug Center (Healthkeeperz Pharmacy)
• Pembroke Drug Center, Inc. (Healthkeeperz)
• Pembroke Drug Center, Inc. (Healthkeeperz DME)
• Pembroke Drug Holdings, LLC (Pembroke Drug)
• Pembroke Drug Holdings, LLC
• Pembroke Optometric Clinic PA
• Pembroke Rescue Squad
• Pembroke Rescue Squad, Inc. (Pembroke Rescue Squad)
• Devan Tyler Penny, ATS
• Victor Mauricio Pereira Sr., PA-C

• Family Medicine Physician in Pembroke, NC
• Providers in Pembroke, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.