| Family Practice Of Eden | |
|
515 Thompson St #d Eden NC 27288-5068 | |
| (336) 627-5178 | |
| Not Available |
| Full Name | Family Practice Of Eden |
|---|---|
| Speciality | Family Medicine |
| Location | 515 Thompson St, Eden, North Carolina |
| Authorized Official Name and Position | Tamara L. Hunt (VP OF PRACTICE MANAGEMENT) |
| Authorized Official Contact | 3366239711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice Of Eden 515 Thompson St #d Eden NC 27288-5068 Ph: (336) 627-5178 | Family Practice Of Eden 515 Thompson St #d Eden NC 27288-5068 Ph: (336) 627-5178 |
| NPI Number | 1629170147 |
|---|---|
| Provider Enumeration Date | 09/04/2006 |
| Last Update Date | 03/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629170147 | NPI | - | NPPES |
| 0129X | Other | NC | BLUE CROSS |
| 235082G | Other | NC | MEDICARE GRP PIN |
| 890129X | Other | NC | MEDICAID GROUP # TERMINATED 3/1/09 |
| 5950636 | Other | NC | MEDICAID GROUP # - EFFECTIVE 1/1/09 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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