# FIRST CARE MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1881989192
- **Authorized official:** DR. BENEDICT ONWUKWE OKWARA (MEDICAL DIRECTOR)
- **Authorized official phone:** (704) 291-9267

## Contact information

- **Practice address:** 1462 CONSTITUTION BLVD, ROCK HILL, SC 29732-3075
- **Practice address phone:** (704) 291-9267
- **Practice address fax:** (704) 283-7939
- **Mailing address:** 404 S SUTHERLAND AVE, MONROE, NC 28112-5060
- **Mailing address phone:** (704) 291-9267
- **Mailing address fax:** (704) 283-7939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |

## Other

- **Enumeration date:** 06/15/2011
- **Last updated:** 09/07/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 025A7 | BCBS OF NC | NC |
| 01 | — | 2326436 | GROUP MEDICARE \# | NC |
| 05 | — | 5917848 | — | NC |
| 05 | — | GP5781 | — | SC |