| Carolina Mercy Medical Clinic Pc | |
|
2101 W Franklin Blvd Gastonia NC 28052-1338 | |
| (704) 867-8855 | |
| (704) 867-1414 |
| Full Name | Carolina Mercy Medical Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2101 W Franklin Blvd, Gastonia, North Carolina |
| Authorized Official Name and Position | Cornelius S Okonkwo (DIRECTOR) |
| Authorized Official Contact | 7048678855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Mercy Medical Clinic Pc 2101 W Franklin Blvd Gastonia NC 28052-1338 Ph: (704) 867-8855 | Carolina Mercy Medical Clinic Pc 2101 W Franklin Blvd Gastonia NC 28052-1338 Ph: (704) 867-8855 |
| NPI Number | 1104154988 |
|---|---|
| Provider Enumeration Date | 12/07/2009 |
| Last Update Date | 02/05/2010 |
| Medicare PECOS PAC ID | 5395888192 |
|---|---|
| Medicare Enrollment ID | O20100202000492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104154988 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 200100074 (North Carolina) | Primary |
| Provider Name | Cornelius S Okonkwo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134235369 PECOS PAC ID: 3678616471 Enrollment ID: I20100202000480 |
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