# CAROLINA HEALTH CLINIC

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

## Provider details

- **NPI number:** 1750923215
- **Authorized official:** LATOSHIA IHENYEN (ADMINISTRATOR)
- **Authorized official phone:** (919) 282-4829

## Contact information

- **Practice address:** 2634 DURHAM CHAPEL HILL BLVD STE 216, DURHAM, NC 27707-2800
- **Practice address phone:** (984) 244-7513
- **Mailing address:** 2634 DURHAM CHAPEL HILL BLVD STE 216, DURHAM, NC 27707-2800
- **Mailing address phone:** (984) 244-7513

## Taxonomy

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

## Other

- **Enumeration date:** 10/16/2019
- **Last updated:** 10/19/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8939668 | — | NC |