| |
273 White Lake Dr Elizabethtown NC 28337-6885 | |
(910) 862-1265 | |
(910) 862-1266 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 273 White Lake Dr, Elizabethtown, North Carolina |
Authorized Official Name and Position | Joseph B Fiser (VP MANAGED CARE & CORPORATE REVENUE) |
Authorized Official Contact | 9106155572 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 40908 Fayetteville NC 28309-0908 Ph: () - | 273 White Lake Dr Elizabethtown NC 28337-6885 Ph: (910) 862-1265 |
NPI Number | 1528559671 |
---|---|
Provider Enumeration Date | 05/24/2018 |
Last Update Date | 11/19/2023 |
Medicare PECOS PAC ID | 6800967969 |
---|---|
Medicare Enrollment ID | O20180810001608 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528559671 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
The Man Cave Testosterone And Wellness, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2816 W Broad St, Elizabethtown, NC 28337 Phone: 910-801-0600 | |
Above & Beyond Wellness - Bladen Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 S Craig St, Elizabethtown, NC 28337 Phone: 910-991-3060 Fax: 910-226-7566 | |