| Boone Trail Medical Center | |
|
1000 Medical Center Road Mamers NC 27552-0397 | |
| (910) 893-3063 | |
| (910) 897-2567 |
| Full Name | Boone Trail Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 Medical Center Road, Mamers, North Carolina |
| Authorized Official Name and Position | Sheila L Simmons (CEO) |
| Authorized Official Contact | 9103640971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boone Trail Medical Center 40 Autumn Fern Trl Lillington NC 27546-5155 Ph: (910) 364-0971 | Boone Trail Medical Center 1000 Medical Center Road Mamers NC 27552-0397 Ph: (910) 893-3063 |
| NPI Number | 1881617850 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 05/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881617850 | NPI | - | NPPES |
| 344509A | Medicaid | NC | |
| 2804129 | Other | NC | MEDICARE PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mobile Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Medical Center Road, Hwy 421, Mamers, NC 27552 Phone: 910-893-5402 Fax: 910-893-2567 |