| Church Street Medical Center And Aesthetics | |
|
214 Church St Nw Lenoir NC 28645-5117 | |
| (276) 239-0338 | |
| Not Available |
| Full Name | Church Street Medical Center And Aesthetics |
|---|---|
| Speciality | Internal Medicine |
| Location | 214 Church St Nw, Lenoir, North Carolina |
| Authorized Official Name and Position | Jennifer Lynn Bennett Williams (OWNER) |
| Authorized Official Contact | 2762390338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Church Street Medical Center And Aesthetics 214 Church St Nw Lenoir NC 28645-5117 Ph: (276) 239-0338 | Church Street Medical Center And Aesthetics 214 Church St Nw Lenoir NC 28645-5117 Ph: (276) 239-0338 |
| NPI Number | 1942981873 |
|---|---|
| Provider Enumeration Date | 07/25/2023 |
| Last Update Date | 07/25/2023 |
| Medicare PECOS PAC ID | 6204287220 |
|---|---|
| Medicare Enrollment ID | O20240103004710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942981873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer L Bennett Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750574935 PECOS PAC ID: 5698861474 Enrollment ID: I20180517002801 |
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