| Halifax Psr | |
|
735 Roanoke Ave Roanoke Rapids NC 27870-2715 | |
| (252) 255-2643 | |
| Not Available |
| Full Name | Halifax Psr |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 735 Roanoke Ave, Roanoke Rapids, North Carolina |
| Authorized Official Name and Position | Kevin L Cochran (FINANCIAL ASSISTANT) |
| Authorized Official Contact | 9199810740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Halifax Psr 1331 Sunday Dr Raleigh NC 27607 Ph: (919) 981-0740 | Halifax Psr 735 Roanoke Ave Roanoke Rapids NC 27870-2715 Ph: (252) 255-2643 |
| NPI Number | 1619003977 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 01/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619003977 | NPI | - | NPPES |
| 8300425S | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-042-040 (North Carolina) | Primary |
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