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301 E Wendover Ave Suite 215 Greensboro NC 27401-1230 | |
| (336) 379-1156 | |
| (336) 370-0442 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 301 E Wendover Ave, Greensboro, North Carolina |
| Authorized Official Name and Position | Terri S. Jones (DIRECTOR, EAGLE BUSINESS SERVICES) |
| Authorized Official Contact | 3362683201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 14883 Greensboro NC 27415-4883 Ph: (336) 379-1156 | 301 E Wendover Ave Suite 215 Greensboro NC 27401-1230 Ph: (336) 379-1156 |
| NPI Number | 1164595757 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 09/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164595757 | NPI | - | NPPES |
| 890134Y | Medicaid | NC | |
| 0134Y | Other | NC | BCBS OF NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
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