| Family Medicine At Eugene Street | |
|
1002 S Eugene St Greensboro NC 27406-1308 | |
| (336) 355-9701 | |
| (336) 676-6140 |
| Full Name | Family Medicine At Eugene Street |
|---|---|
| Speciality | Clinic/Center |
| Location | 1002 S Eugene St, Greensboro, North Carolina |
| Authorized Official Name and Position | Brian K Ellerby (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3363559696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine At Eugene Street 1002 S Eugene St Greensboro NC 27406-1308 Ph: (336) 355-9701 | Family Medicine At Eugene Street 1002 S Eugene St Greensboro NC 27406-1308 Ph: (336) 355-9701 |
| NPI Number | 1063712727 |
|---|---|
| Provider Enumeration Date | 10/28/2010 |
| Last Update Date | 11/26/2013 |
| Medicare PECOS PAC ID | 1850311986 |
|---|---|
| Medicare Enrollment ID | O20111011000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063712727 | NPI | - | NPPES |
| 34D0700291 | Other | CLIA | |
| 2348638A | Other | NC | MEDICARE PART B |
| 344045A | Medicaid | NC | |
| 3460247 | Other | NCPDP | |
| 56162 | Other | NC | MEDCOST |
| 34-1962 | Other | NC | MEDICARE PART A |
| 344045B | Medicaid | NC | |
| 344045C | Medicaid | NC | |
| 024UF | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | 10670 (North Carolina) | Secondary |
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