Organization
EASTOVER FAMILY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE LYNN FARMER PA (AUTHORIZED OFFICIAL)
(910) 483-6277
Entity
Organization
Contact information
Practice address
3551 DUNN RD, SUITE 101, EASTOVER, NC 28312-8794
(910) 483-6277
(910) 483-6285
Mailing address
3947 DUNN RD # 304, EASTOVER, NC 28312-8533
(910) 483-6277
(910) 483-6285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2335746
MEDICARE
NC
05
—
5908812
—
NC
Enumeration date
01/23/2008
Last updated
11/05/2021
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