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307 E Thom St China Grove NC 28023-2363 | |
(704) 792-2245 | |
(704) 792-2250 |
Full Name | |
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Speciality | Clinic/Center |
Location | 307 E Thom St, China Grove, North Carolina |
Authorized Official Name and Position | Don Holloman (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 7047922203 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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202d Mcgill Ave Nw Concord NC 28025-4615 Ph: (704) 792-2242 | 307 E Thom St China Grove NC 28023-2363 Ph: (704) 792-2245 |
NPI Number | 1528304235 |
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Provider Enumeration Date | 12/27/2012 |
Last Update Date | 08/17/2020 |
Medicare PECOS PAC ID | 9638197635 |
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Medicare Enrollment ID | O20130701000507 |
Identifier | Type | State | Issuer |
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1528304235 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 207Q00000X (North Carolina) | Primary |
Main Street Family Practice Of China Grove Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 302 S Main St, China Grove, NC 28023 Phone: 704-857-8769 Fax: 704-857-8779 | |
Novant Health Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1965 S Us 29 Hwy, China Grove, NC 28023 Phone: 704-855-8338 Fax: 704-855-8339 | |
Main Street Family Practice Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 S Main Street, China Grove, NC 28023 Phone: 704-857-8769 Fax: 704-857-8779 | |