# CAROLINA'S MEDICAL & WELLNESS CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1710790985
- **Authorized official:** JENNIFER COUGHENOUR NP (OWNER)
- **Authorized official phone:** (910) 506-8474

## Contact information

- **Practice address:** 821A S MAIN ST, LAURINBURG, NC 28352-4724
- **Practice address phone:** (910) 506-8474
- **Practice address fax:** (855) 136-1881
- **Mailing address:** PO BOX 888, LAURINBURG, NC 28353-0888
- **Mailing address phone:** (910) 506-8474
- **Mailing address fax:** (855) 136-1881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/30/2025
- **Last updated:** 01/30/2025
