| |
1151 Main Street, Swanquarter, NC 27885-1151 | |
(252) 926-4200 | |
(252) 926-3702 |
Full Name | |
---|---|
Type | Facility |
Speciality | Dietitian, Registered |
Location | 1151 Main Street, Swanquarter, North Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376841627 | NPI | - | NPPES |
2800839 | Other | MEDICARE - IMMUNIZATIONS | |
1962405159 | Other | NPI | |
3404348 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Po Box 100, Swanquarter, NC 27885-0100 Ph: (252) 926-4200 | 1151 Main Street, Swanquarter, NC 27885-1151 Ph: (252) 926-4200 |