| Three Rivers Medical Center | |
|
580 W Mclean St Saint Pauls NC 28384-1421 | |
| (910) 615-3570 | |
| (910) 865-3503 |
| Full Name | Three Rivers Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 580 W Mclean St, Saint Pauls, North Carolina |
| Authorized Official Name and Position | Joseph B Fiser (VP MANAGED CARE AND REVENUE CYCLE) |
| Authorized Official Contact | 9106155572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Three Rivers Medical Center Po Box 40908 Fayetteville NC 28309-0908 Ph: (910) 615-6448 | Three Rivers Medical Center 580 W Mclean St Saint Pauls NC 28384-1421 Ph: (910) 615-3570 |
| NPI Number | 1750616108 |
|---|---|
| Provider Enumeration Date | 10/02/2009 |
| Last Update Date | 11/30/2023 |
| Medicare PECOS PAC ID | 2567506942 |
|---|---|
| Medicare Enrollment ID | O20100223000688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750616108 | NPI | - | NPPES |
| PENDING | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amita S Shetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548267958 PECOS PAC ID: 4284624750 Enrollment ID: I20040517000155 |
| Provider Name | Tracy E Bullard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255334736 PECOS PAC ID: 1456324839 Enrollment ID: I20040813001060 |
| Provider Name | Johnnie L Moultrie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609882117 PECOS PAC ID: 7113027848 Enrollment ID: I20070711000229 |
St. Pauls Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 E Broad St, Saint Pauls, NC 28384 Phone: 910-865-5955 Fax: 910-865-3055 | |
The Clinic At Brisson Drug Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 217 W Broad St, Saint Pauls, NC 28384 Phone: 910-241-3078 | |
St Pauls Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 128 E Broad St, Saint Pauls, NC 28384 Phone: 910-241-3042 Fax: 910-241-3462 | |
Primary Care Of St. Pauls Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 E Blue St, Saint Pauls, NC 28384 Phone: 910-865-5177 Fax: 910-865-9400 | |
St Pauls Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 E Broad St, Saint Pauls, NC 28384 Phone: 910-865-5955 Fax: 910-865-3055 | |
St. Pauls Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 128 E Broad St, Saint Pauls, NC 28384 Phone: 910-865-5955 Fax: 910-738-3764 |