| Iredell Psr | |
|
231 Twin Oaks Rd Statesville NC 28625-6431 | |
| (919) 981-0740 | |
| Not Available |
| Full Name | Iredell Psr |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 231 Twin Oaks Rd, Statesville, 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 |
|---|---|
| Iredell Psr 1331 Sunday Dr Raleigh NC 27607 Ph: (919) 981-0740 | Iredell Psr 231 Twin Oaks Rd Statesville NC 28625-6431 Ph: (919) 981-0740 |
| NPI Number | 1598891400 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598891400 | NPI | - | NPPES |
| 8300481S | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-049-065 (North Carolina) | Primary |
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