Elitecare Of Fayetteville Pllc | |
3622 N Main St Hope Mills NC 28348-1937 | |
(910) 423-7771 | |
(910) 423-4177 |
Full Name | Elitecare Of Fayetteville Pllc |
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Speciality | Clinic/Center |
Location | 3622 N Main St, Hope Mills, North Carolina |
Authorized Official Name and Position | Travis Sanders Ross (ORGANIZER/MEMBER) |
Authorized Official Contact | 9105518882 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Elitecare Of Fayetteville Pllc 3622 N Main St Hope Mills NC 28348-1937 Ph: (910) 423-7771 | Elitecare Of Fayetteville Pllc 3622 N Main St Hope Mills NC 28348-1937 Ph: (910) 423-7771 |
NPI Number | 1508297003 |
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Provider Enumeration Date | 12/09/2013 |
Last Update Date | 12/09/2013 |
Medicare PECOS PAC ID | 0749419893 |
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Medicare Enrollment ID | O20140212001136 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508297003 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Provider Name | Kenneth E Locklear |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275530594 PECOS PAC ID: 8123073566 Enrollment ID: I20050317000916 |
Fhpg, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3622 N Main St, Hope Mills, NC 28348 Phone: 910-423-7771 Fax: 910-423-4177 | |
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Lakeview Urgent Care And Family Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3622 N Main St, Hope Mills, NC 28348 Phone: 910-423-7771 Fax: 910-423-4177 |