| |
137 Highway 49 N Richfield NC 28137-5738 | |
(704) 463-6521 | |
(704) 463-0400 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 137 Highway 49 N, Richfield, North Carolina |
Authorized Official Name and Position | Daniel L Wiens (SENIOR VICE PRESIDENT - OPERATIONS) |
Authorized Official Contact | 7043550648 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 602120 Charlotte NC 28260-2120 Ph: (704) 463-6521 | 137 Highway 49 N Richfield NC 28137-5738 Ph: (704) 463-6521 |
NPI Number | 1669602504 |
---|---|
Provider Enumeration Date | 07/24/2009 |
Last Update Date | 07/29/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669602504 | NPI | - | NPPES |
7705277 | Other | NC | NC MEDICAID DME |
5907422 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |