| General Medical Clinic, Pa | |
|
2003 Boulevard St Ste C Greensboro NC 27407-4579 | |
| (336) 633-0407 | |
| (336) 633-0410 |
| Full Name | General Medical Clinic, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 2003 Boulevard St Ste C, Greensboro, North Carolina |
| Authorized Official Name and Position | Tarshia Donnell (REGIONAL DIRECTOR) |
| Authorized Official Contact | 3363014264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| General Medical Clinic, Pa Po Box 788 Greensboro NC 27402-0788 Ph: (336) 301-4264 | General Medical Clinic, Pa 2003 Boulevard St Ste C Greensboro NC 27407-4579 Ph: (336) 633-0407 |
| NPI Number | 1871522003 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 12/07/2023 |
| Certification Date | 12/07/2023 |
| Medicare PECOS PAC ID | 8820001423 |
|---|---|
| Medicare Enrollment ID | O20060727000269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871522003 | NPI | - | NPPES |
| 5902980 | Medicaid | NC |
| Provider Name | Janis Panzenhagen Puglisi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114017498 PECOS PAC ID: 9931163037 Enrollment ID: I20041118000215 |
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