| Commwell Health Of Shallotte | |
|
341a Whiteville Rd Nw Shallotte NC 28470-4507 | |
| (877) 935-5255 | |
| (910) 236-2118 |
| Full Name | Commwell Health Of Shallotte |
|---|---|
| Speciality | Clinic/Center |
| Location | 341a Whiteville Rd Nw, Shallotte, North Carolina |
| Authorized Official Name and Position | William Clay Ellison (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 9105677065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Commwell Health Of Shallotte Po Box 340 Four Oaks NC 27524-0340 Ph: (910) 567-6194 | Commwell Health Of Shallotte 341a Whiteville Rd Nw Shallotte NC 28470-4507 Ph: (877) 935-5255 |
| NPI Number | 1003218439 |
|---|---|
| Provider Enumeration Date | 09/17/2014 |
| Last Update Date | 03/27/2024 |
| Medicare PECOS PAC ID | 2163409558 |
|---|---|
| Medicare Enrollment ID | O20141226000441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003218439 | NPI | - | NPPES |
| 2804165 | Other | NC | MEDICARE PIN |
| 341026 | Other | MEDICARE OSCAR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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