Organization
FIRST CARE MEDICAL CLINIC
Active
Organization
FIRST CARE MEDICAL CLINIC
Active
Other names
FIRST CARE MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
BENEDICT O OKWARA MD (MEDICAL DIRECTOR)
(704) 291-9267
Entity
Organization
Contact information
Practice address
1426 E MAIN ST, ALBEMARLE, NC 28001-5236
(704) 982-0950
Mailing address
404 S SUTHERLAND AVE, MONROE, NC 28112-5060
(704) 982-0950
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012HW
BCBSNC
NC
01
—
2326436
MEDICARE GROUP #
NC
05
—
89012HW
—
NC
01
—
QPA311
SOUTHCAROLINA MEDICAID
SC
Enumeration date
03/21/2007
Last updated
04/13/2010
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