| Roanoke Rapids North | |
|
2307 Norwood Ave Ste A Goldsboro NC 27534-1601 | |
| (919) 734-8803 | |
| (919) 735-6825 |
| Full Name | Roanoke Rapids North |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2307 Norwood Ave Ste A, Goldsboro, North Carolina |
| Authorized Official Name and Position | Tracey Pridgen (CFO) |
| Authorized Official Contact | 9197348803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roanoke Rapids North Po Box 11077 Goldsboro NC 27532-1077 Ph: (919) 734-8803 | Roanoke Rapids North 2307 Norwood Ave Ste A Goldsboro NC 27534-1601 Ph: (919) 734-8803 |
| NPI Number | 1649574450 |
|---|---|
| Provider Enumeration Date | 01/08/2011 |
| Last Update Date | 09/30/2024 |
| Certification Date | 09/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649574450 | NPI | - | NPPES |
| 8300824 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-042-059 (North Carolina) | Primary |
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