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Organization
PRIMARY HEALTH CHOICE, INC.
Active
Organization
PRIMARY HEALTH CHOICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THAD J. DAVIS (DIRECTOR)
(910) 865-3500
Entity
Organization
Contact information
Practice address
755 S MAIN ST, RAEFORD, NC 28376-3238
(910) 875-1485
(910) 875-1567
Mailing address
PO BOX 159, SAINT PAULS, NC 28384-0159
(910) 865-3500
(910) 865-3874
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2802374G
—
NC
05
—
8302374
—
NC
05
—
8302374H
—
NC
05
—
8302374R
—
NC
Enumeration date
06/04/2007
Last updated
03/03/2014
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