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111 E Main St Conway NC 27820-0348 | |
| (252) 585-1134 | |
| (252) 585-0274 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 E Main St, Conway, North Carolina |
| Authorized Official Name and Position | Francis Marvin Taylor (CFO DOCTOR) |
| Authorized Official Contact | 2525851134 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 348 Conway NC 27820-0348 Ph: (252) 585-1134 | 111 E Main St Conway NC 27820-0348 Ph: (252) 585-1134 |
| NPI Number | 1669687851 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 10/23/2015 |
| Medicare PECOS PAC ID | 6204865710 |
|---|---|
| Medicare Enrollment ID | O20050804001159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669687851 | NPI | - | NPPES |
| 013N7 | Other | NC | BLUE CROSS BLUE SHIELD |
| 89013N7 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 9900696 (North Carolina) | Primary |
| Provider Name | Francis M Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336222157 PECOS PAC ID: 0648233395 Enrollment ID: I20041104000612 |