Organization
CAROLINA EXPRESS CARE SELMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE WHITE (CEO)
(919) 217-1411
Entity
Organization
Contact information
Practice address
108 S RAIFORD ST, SELMA, NC 27576-3155
(919) 217-1411
(919) 217-3084
Mailing address
502 MCKNIGHT DR, KNIGHTDALE, NC 27545-7050
(919) 217-1411
(919) 217-3084
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
101583
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89015EF
—
NC
Enumeration date
11/01/2006
Last updated
08/22/2020
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