# FAMHEALTH PRIMARY CARE , PA

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

## Provider details

- **NPI number:** 1568916617
- **Authorized official:** MS. ENID MATOS TALLMER PA-C (PRESIDENT)
- **Authorized official phone:** (919) 697-5388

## Contact information

- **Practice address:** 5720 CREEDMOOR RD, RALEIGH, NC 27612-2256
- **Practice address phone:** (919) 782-0430
- **Mailing address:** 5720 CREEDMOOR RD, RALEIGH, NC 27612-2256
- **Mailing address phone:** (919) 782-0430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | C2016204005421 | NC | Yes |

## Other

- **Enumeration date:** 08/06/2016
- **Last updated:** 08/06/2016