| Port Health Services | |
|
1309 Tatum Dr New Bern NC 28560-4314 | |
| (252) 672-8742 | |
| (252) 638-3742 |
| Full Name | Port Health Services |
|---|---|
| Speciality | Counselor |
| Location | 1309 Tatum Dr, New Bern, North Carolina |
| Authorized Official Name and Position | Brett Beavers (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9192107661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Health Services 4300 Sapphire Ct Ste 110 Greenville NC 27834-9079 Ph: (252) 830-7540 | Port Health Services 1309 Tatum Dr New Bern NC 28560-4314 Ph: (252) 672-8742 |
| NPI Number | 1659420487 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 05/24/2023 |
| Certification Date | 05/24/2023 |
| Medicare PECOS PAC ID | 5193752681 |
|---|---|
| Medicare Enrollment ID | O20200220002200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659420487 | NPI | - | NPPES |
| 5903642 | Medicaid | NC | |
| 6005885 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | MHL-025-204 (North Carolina) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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