# COLUMBUS PEDIATRICS & ADOLESCENT CARE PA

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

## Provider details

- **NPI number:** 1447210976
- **Authorized official:** DR. COY RANDOLPH MATTHEWS M.D. (PRESIDENT OF CORPORATION)
- **Authorized official phone:** (910) 642-2642

## Contact information

- **Practice address:** 800 JEFFERSON ST, SUITE 116, WHITEVILLE, NC 28472-3710
- **Practice address phone:** (910) 642-2642
- **Practice address fax:** (910) 642-3346
- **Mailing address:** 800 JEFFERSON ST, SUITE 116, WHITEVILLE, NC 28472-3702
- **Mailing address phone:** (910) 642-2642
- **Mailing address fax:** (910) 642-3346

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | 36388 | NC | Yes |

## Other

- **Enumeration date:** 03/27/2006
- **Last updated:** 02/07/2008