FAMILY WELLNESS CLINIC
NPI 1164865416
Non-Pharmacy Dispensing Site in Clayton, NC

Active since April 16, 2013
2076 HIGHWAY 42 WEST, SUITE 230, CLAYTON, NC 27520(919) 553-5711 Get Directions Write a Review

NPPES record last updated: April 16, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Non-Pharmacy Dispensing Site

About FAMILY WELLNESS CLINIC

This page provides the complete NPI Profile along with additional information for Family Wellness Clinic, a provider established in Clayton, North Carolina operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1164865416 assigned on April 2013. The practitioner's primary taxonomy code is 332900000X with license number 200400430 (NC). The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Family Wellness Clinic. The authorized official of this NPI record is Kenny Heine (Vp Of Operations)

NPI
1164865416 Verify this NPI
Provider Legal Name
RALEIGH DURHAM MEDICAL GROUP PA
Other Organization Name
FAMILY WELLNESS CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2076 HIGHWAY 42 WEST SUITE 230 CLAYTON, NC 27520
Location Phone
(919) 553-5711
Mailing Address
5626 OBERLIN DR SUITE 110 SAN DIEGO, CA 92121
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
04-16-2013
Last Update Date
04-16-2013
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Non-Pharmacy Dispensing Site

Taxonomy Code
332900000X
Type
Suppliers
License No.
200400430
License State
NC
Taxonomy Description
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KENNY HEINE

Authorized Official Title
VP OF OPERATIONS
Authorized Official Phone
(858) 964-1506

Reviews for FAMILY WELLNESS CLINIC

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Physician Assistant
2076 HIGHWAY 42 WEST
CLAYTON, NC 27520

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164865416, enumerated as an "organization" on April 16, 2013.

The provider is located at 2076 HIGHWAY 42 WEST SUITE 230 CLAYTON, NC 27520 and the phone number is (919) 553-5711.

Non-Pharmacy Dispensing Site with taxonomy code 332900000X.