# CALABASH PRIMARY CARE LLC

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

## Provider details

- **NPI number:** 1528139987
- **Authorized official:** CATHY SELLERS SR. NURSE PRACTICIONER (OWNER)
- **Authorized official phone:** (910) 575-6538

## Contact information

- **Practice address:** 10195 BEACH DR SW \# 5, CALABASH, NC 28467-2701
- **Practice address phone:** (910) 575-6538
- **Practice address fax:** (910) 575-6541
- **Mailing address:** 10195 BEACH DR SW \# 5, CALABASH, NC 28467-2701
- **Mailing address phone:** (910) 575-6538
- **Mailing address fax:** (910) 575-6541

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 27938 | NC | Yes |
| 363A00000X | Physician Assistant | 27331 | NC | — |
| 363L00000X | Nurse Practitioner | 201575 | NC | — |

## Other

- **Enumeration date:** 11/10/2006
- **Last updated:** 06/04/2009

## 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 |