# FAYETTEVILLE AREA HEALTH EDUCATION FOUNDATION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Regional AHEC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639625106
- **Authorized official:** DR. SUSHMA KAPOOR M.D. (VP CEAS)
- **Authorized official phone:** (910) 678-0100

## Contact information

- **Practice address:** 1601 OWEN DR, FAYETTEVILLE, NC 28304-3425
- **Practice address phone:** (910) 678-0100
- **Practice address fax:** (910) 678-0115
- **Mailing address:** 1601 OWEN DR, FAYETTEVILLE, NC 28304-3425
- **Mailing address phone:** (910) 678-0100
- **Mailing address fax:** (910) 678-0115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | L004639 | NC | Yes |

## Other

- **Enumeration date:** 08/25/2016
- **Last updated:** 08/25/2016