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Organization

PINEHURST MEDICAL CLINIC, INC.

Active
Other names
PMC Reference Lab
Organization subpart
No

Provider details

NPI number
Authorized official
BRANDON ENFINGER (CEO)
(910) 235-3004
Entity
Organization

Contact information

Practice address
200 PAVILION WAY, SOUTHERN PINES, NC 28387-4561
(910) 639-9088
Mailing address
205 PAGE RD, PINEHURST, NC 28374-8798
(910) 295-5511
(910) 235-3443

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
39578
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02418
BC/BS NC
01
690003763
PALMETTO GBA (R/R MCR)
05
7001306
NC
01
FH6600055
FIRSTCAROLINACARE
Enumeration date
09/20/2006
Last updated
09/13/2022
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