| Evergreen Health Promotion,p.a. | |
|
1365 Westgate Center Dr Ste G1 Winston Salem NC 27103 | |
| (336) 659-6250 | |
| (336) 659-6250 |
| Full Name | Evergreen Health Promotion,p.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1365 Westgate Center Dr, Winston Salem, North Carolina |
| Authorized Official Name and Position | Naomi Hanna Greenberg (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 3366590020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Health Promotion,p.a. 1365 Westgate Center Dr Ste G1 Winston Salem NC 27103 Ph: (336) 659-6250 | Evergreen Health Promotion,p.a. 1365 Westgate Center Dr Ste G1 Winston Salem NC 27103 Ph: (336) 659-6250 |
| NPI Number | 1154332971 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 09/22/2022 |
| Medicare PECOS PAC ID | 2567565393 |
|---|---|
| Medicare Enrollment ID | O20070314000629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154332971 | NPI | - | NPPES |
| 8916312 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert Lee Bloomfield |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962496810 PECOS PAC ID: 9830292663 Enrollment ID: I20070314000626 |
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