| Impact Carolina Services Inc. | |
|
106 Doctors Park Lincolnton NC 28092-4406 | |
| (704) 533-0277 | |
| (704) 685-5937 |
| Full Name | Impact Carolina Services Inc. |
|---|---|
| Speciality | Counselor |
| Location | 106 Doctors Park, Lincolnton, North Carolina |
| Authorized Official Name and Position | Joseph Olatunde Adedokun (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7045330277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Carolina Services Inc. 3080 Jamestown Dr Gastonia NC 28054-6056 Ph: (704) 533-0277 | Impact Carolina Services Inc. 106 Doctors Park Lincolnton NC 28092-4406 Ph: (704) 533-0277 |
| NPI Number | 1376789925 |
|---|---|
| Provider Enumeration Date | 01/05/2009 |
| Last Update Date | 01/05/2009 |
| Medicare PECOS PAC ID | 7719019355 |
|---|---|
| Medicare Enrollment ID | O20100719000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376789925 | NPI | - | NPPES |
| 6111767 | Medicaid | NC |
| Provider Name | Julie Parker Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912282674 PECOS PAC ID: 0446423305 Enrollment ID: I20111109000667 |
| Provider Name | Novlett S Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326462524 PECOS PAC ID: 9436373396 Enrollment ID: I20150204002454 |
| Provider Name | Esther O Adedokun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285379081 PECOS PAC ID: 8820477425 Enrollment ID: I20220805001677 |
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