| |
20 Medical Campus Dr Supply NC 28462 | |
(910) 755-6300 | |
(910) 755-2364 |
Full Name | |
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Speciality | Family Medicine |
Location | 20 Medical Campus Dr, Supply, North Carolina |
Authorized Official Name and Position | Bernard Leroy Langston (PRESIDENT) |
Authorized Official Contact | 9107548731 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2528 Chicora Urgent Care Shallotte NC 28459 Ph: (910) 755-6300 | 20 Medical Campus Dr Supply NC 28462 Ph: (910) 755-6300 |
NPI Number | 1861461204 |
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Provider Enumeration Date | 03/17/2006 |
Last Update Date | 12/13/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861461204 | NPI | - | NPPES |
5900665 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Holden Beach Medical Center, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2930 Holden Beach Rd Sw, Supply, NC 28462 Phone: 910-842-5991 Fax: 910-842-5994 | |
Church Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 Medical Campus Dr, Suite 203, Supply, NC 28462 Phone: 910-755-7181 Fax: 910-755-7194 | |
Coastal Gastroenterology Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 Medical Center Drive, Supply, NC 28462 Phone: 910-754-7790 Fax: 910-754-7838 |