Collettsville Medical Center | |
4330 Collettsville Rd Collettsville NC 28611-9000 | |
(828) 754-2409 | |
(828) 754-2418 |
Full Name | Collettsville Medical Center |
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Speciality | Clinic/Center |
Location | 4330 Collettsville Rd, Collettsville, North Carolina |
Authorized Official Name and Position | Thomas Benjamin Mcrary (ASSISTANT ADMINISTRATOR) |
Authorized Official Contact | 8287542409 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Collettsville Medical Center 4330 Collettsville Rd Po Drawer 9 Collettsville NC 28611-9000 Ph: (828) 754-2409 | Collettsville Medical Center 4330 Collettsville Rd Collettsville NC 28611-9000 Ph: (828) 754-2409 |
NPI Number | 1346302429 |
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Provider Enumeration Date | 12/14/2006 |
Last Update Date | 06/29/2016 |
Medicare PECOS PAC ID | 4385651876 |
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Medicare Enrollment ID | O20060308000287 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346302429 | NPI | - | NPPES |
344038 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Jeffery S Anderson |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1497715833 PECOS PAC ID: 0941198998 Enrollment ID: I20040317001055 |
Provider Name | James R Thompson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760422620 PECOS PAC ID: 5496870685 Enrollment ID: I20100910000947 |
Provider Name | Traci Myers White |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891166328 PECOS PAC ID: 5092015495 Enrollment ID: I20151207002003 |
Provider Name | Janet Denise Minton |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1073806451 PECOS PAC ID: 8628302072 Enrollment ID: I20191105000504 |
Provider Name | Sandra St Louis Thompson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013525310 PECOS PAC ID: 1759786460 Enrollment ID: I20211013002215 |
Provider Name | Carmen Mcneil Givens |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1508267030 PECOS PAC ID: 3678942349 Enrollment ID: I20221220001326 |
Provider Name | Allie Catherine Craciun |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710684717 PECOS PAC ID: 9335506716 Enrollment ID: I20230530001582 |
West Caldwell Mobile Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4330 Collettsville Rd, Collettsville, NC 28611 Phone: 828-754-2409 Fax: 828-754-2418 |