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Organization

LONG BEACH FAMILY MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GEORGE THOMAS HOLLAND M. D. (PHYSICIAN)
(910) 278-3500
Entity
Organization

Contact information

Practice address
4700 E OAK ISLAND DR, SUITE F, OAK ISLAND, NC 28465-5200
(910) 278-3500
(910) 278-7233
Mailing address
2006 ROBERT RUARK DR, S E, SOUTHPORT, NC 28461-2652
(910) 457-0595

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
0039512
NC
261QP2300X
Primary Care Clinic/Center
Primary
39512
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
207Q00000X
MEDICARE TAXOMONY
NC
05
8943093
NC
Enumeration date
01/18/2006
Last updated
08/25/2008
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