Organization
PINEHURST MEDICAL CLINIC, INC.
Active
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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