# BEACH PRIMARY CARE AND WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053103796
- **Authorized official:** DR. MARY RUDD CRICHTON DNP (FAMILY NURSE PRACTITIONER)
- **Authorized official phone:** (910) 755-1200

## Contact information

- **Practice address:** 863 OCEAN HWY W, SUPPLY, NC 28462-4059
- **Practice address phone:** (910) 995-7022
- **Mailing address:** 863 OCEAN HWY W, SUPPLY, NC 28462-4059
- **Mailing address phone:** (910) 755-1200
- **Mailing address fax:** (910) 755-1064

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/19/2025
- **Last updated:** 03/26/2026