| Addiction Recovery Medical Services | |
|
536 Signal Hill Drive Ext Statesville NC 28625-4391 | |
| (704) 872-0234 | |
| Not Available |
| Full Name | Addiction Recovery Medical Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 536 Signal Hill Drive Ext, Statesville, North Carolina |
| Authorized Official Name and Position | Susan H Large (BILLING MANAGER) |
| Authorized Official Contact | 8034173239 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Addiction Recovery Medical Services Po Box 1545 Statesville NC 28687-1545 Ph: (704) 872-0234 | Addiction Recovery Medical Services 536 Signal Hill Drive Ext Statesville NC 28625-4391 Ph: (704) 872-0234 |
| NPI Number | 1487887949 |
|---|---|
| Provider Enumeration Date | 09/01/2009 |
| Last Update Date | 02/13/2021 |
| Certification Date | 02/13/2021 |
| Medicare PECOS PAC ID | 5496080046 |
|---|---|
| Medicare Enrollment ID | O20190718001331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487887949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 9300179 (North Carolina) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Bobby P Kearney |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1437172012 PECOS PAC ID: 1456445923 Enrollment ID: I20070915000100 |
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