| Fairmont Medical Clinic | |
|
101 N Walnut St Fairmont NC 28340-1951 | |
| (910) 628-0655 | |
| (910) 628-0158 |
| Full Name | Fairmont Medical Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 101 N Walnut St, Fairmont, North Carolina |
| Authorized Official Name and Position | Charles Thomas Johnson (VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9106715090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairmont Medical Clinic 2600 N Elm St Lumberton NC 28358-3011 Ph: (910) 272-3051 | Fairmont Medical Clinic 101 N Walnut St Fairmont NC 28340-1951 Ph: (910) 628-0655 |
| NPI Number | 1194720466 |
|---|---|
| Provider Enumeration Date | 06/14/2005 |
| Last Update Date | 01/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194720466 | NPI | - | NPPES |
| 0260K | Other | NC | BLUE CROSS BLUE SHIELD |
| 343989A | Medicaid | NC | |
| 343989C | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | H0064 (North Carolina) | Primary |
Robeson Health Care Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 S Walnut Street, Fairmont, NC 28340 Phone: 910-521-2900 Fax: 910-775-9165 | |
Fairmont Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Walnut St, Fairmont, NC 28340 Phone: 910-628-0655 Fax: 910-738-3764 |