| Smith Family Wellness Clinic | |
|
3622 Central Ave Charlotte NC 28205-5638 | |
| (704) 316-6561 | |
| (704) 384-1977 |
| Full Name | Smith Family Wellness Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3622 Central Ave, Charlotte, North Carolina |
| Authorized Official Name and Position | Stefani Priscilia Ruarte (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7043166573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smith Family Wellness Clinic 8401 Medical Plaza Dr Ste 300 Charlotte NC 28262-8702 Ph: (704) 316-6561 | Smith Family Wellness Clinic 3622 Central Ave Charlotte NC 28205-5638 Ph: (704) 316-6561 |
| NPI Number | 1053065201 |
|---|---|
| Provider Enumeration Date | 02/07/2022 |
| Last Update Date | 08/15/2022 |
| Medicare PECOS PAC ID | 0840502274 |
|---|---|
| Medicare Enrollment ID | O20230518001415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053065201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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