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611 Randolph St Thomasville NC 27360-5126 | |
(336) 474-4585 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 611 Randolph St, Thomasville, North Carolina |
Authorized Official Name and Position | Sharmila Alexander Anderson (BUSINESS SERVICE ADMINISTRATOR) |
Authorized Official Contact | 7048741907 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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200 E Second Ave Gastonia NC 28052-4358 Ph: (704) 874-1907 | 611 Randolph St Thomasville NC 27360-5126 Ph: (336) 474-4585 |
NPI Number | 1225445331 |
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Provider Enumeration Date | 07/21/2014 |
Last Update Date | 07/07/2020 |
Medicare PECOS PAC ID | 5496733925 |
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Medicare Enrollment ID | O20150123000549 |
Identifier | Type | State | Issuer |
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1225445331 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Evernorth Direct Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 550 Cloniger Dr, Thomasville, NC 27360 Phone: 336-870-2476 Fax: 336-313-4289 | |