Organization
PHYSICIANS ELDERCARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE HOWARD (SR VP OF ADMINISTRATIVE SERVICES)
(337) 408-0797
Entity
Organization
Contact information
Practice address
5306 NC HIGHWAY 55 STE 105, DURHAM, NC 27713-7812
(337) 991-9276
(337) 943-0846
Mailing address
5750 JOHNSTON ST STE 205, LAFAYETTE, LA 70503-5334
(337) 408-0797
(337) 943-0846
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012WF
BCBS
NC
05
—
89012WF
—
NC
01
—
CH9289
RR MRC
—
01
—
H140/45282
PARTNERS
—
Enumeration date
02/21/2006
Last updated
07/24/2025
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