| Organization Name: | CAROLINA RURAL PRACTICE MANAGEMENT, INC. |
| NPI Number: | 1811020183 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLIE CLIFTON ALSBROOKS (ADMINISTRATOR) |
| Mailing Address: | 120 Louie Street Wagener |
| State: | SC US |
| Postal Code: | 291640098 |
| Phone Number: | 8035646497 |
| Fax Number: | 8035646498 |
| NPI Enumeration Date: | 03/14/2007 |
| NPI Last Update Date: | 07/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 08504 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |