Organization
INNOVATIVE FAMILY CARE OF THE CAROLINA'S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAWNTEL LEE PICHARDO (PRESIDENT)
(919) 264-3398
Entity
Organization
Contact information
Practice address
2515 NC HWY 55, SUITE B, DURHAM, NC 27713-1374
(919) 596-0094
Mailing address
2515 NC HWY 55, SUITE B, DURHAM, NC 27713-1374
(919) 596-0094
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
10/18/2011
Last updated
10/18/2011
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