Organization
CARDINAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY GARCIA (QM COORDINATOR)
(910) 864-0187
Entity
Organization
Contact information
Practice address
160 PINEHURST AVE STE J, SOUTHERN PINES, NC 28387-7078
(910) 693-7777
(910) 693-1524
Mailing address
1540 PURDUE DR STE 200, FAYETTEVILLE, NC 28303-5510
(910) 867-8889
(910) 487-3061
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300367
—
NC
Enumeration date
12/19/2006
Last updated
05/20/2009
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