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210 Bridge St Ste 102 Smithfield NC 27577-3904 | |
| (919) 989-9936 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 210 Bridge St Ste 102, Smithfield, North Carolina |
| Authorized Official Name and Position | Kevin Cochran (FINANCIAL ASSISTANT) |
| Authorized Official Contact | 9199810740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1331 Sunday Dr Raleigh NC 27609 Ph: (919) 981-0740 | 210 Bridge St Ste 102 Smithfield NC 27577-3904 Ph: (919) 989-9936 |
| NPI Number | 1053444083 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053444083 | NPI | - | NPPES |
| 8300434G | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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