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Organization
CALABASH PRIMARY CARE LLC
Active
Organization
CALABASH PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY SELLERS SR. NURSE PRACTICIONER (OWNER)
(910) 575-6538
Entity
Organization
Contact information
Practice address
10195 BEACH DR SW # 5, CALABASH, NC 28467-2701
(910) 575-6538
(910) 575-6541
Mailing address
10195 BEACH DR SW # 5, CALABASH, NC 28467-2701
(910) 575-6538
(910) 575-6541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27938
NC
363A00000X
Physician Assistant
27331
NC
363L00000X
Nurse Practitioner
201575
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098806
—
SC
01
—
10048
BLUE CROSS & BLUE SHIELD
NC
01
—
203024
MEDICARE
NC
05
—
89131FG
—
NC
05
—
8950904
—
NC
01
—
DB2289
RAILROAD MEDICARE
NC
Enumeration date
11/10/2006
Last updated
06/04/2009
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