| Sunpath Llc | |
|
415 W Main Ave Gastonia NC 28052-3844 | |
| (704) 478-6093 | |
| Not Available |
| Full Name | Sunpath Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 415 W Main Ave, Gastonia, North Carolina |
| Authorized Official Name and Position | Alonzo Morrow (PROGRAM DIRECTOR) |
| Authorized Official Contact | 7044786093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunpath Llc Po Box 864 Gastonia NC 28053-0864 Ph: () - | Sunpath Llc 415 W Main Ave Gastonia NC 28052-3844 Ph: (704) 478-6093 |
| NPI Number | 1285705467 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 07/08/2008 |
| Medicare PECOS PAC ID | 5991967440 |
|---|---|
| Medicare Enrollment ID | O20120430000788 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285705467 | NPI | - | NPPES |
| 8300453B | Medicaid | NC | |
| 8300453H | Medicaid | NC | |
| 8300453F | Medicaid | NC | |
| 8300453 | Medicaid | NC | |
| 8300453G | Medicaid | NC | |
| 6006091 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Guangbin Zeng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851332928 PECOS PAC ID: 8820093909 Enrollment ID: I20060922000557 |
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