| Farmville Internal Medicine Pa | |
|
3485 N Main St Farmville NC 27828-1466 | |
| (252) 753-3193 | |
| (252) 753-7966 |
| Full Name | Farmville Internal Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 3485 N Main St, Farmville, North Carolina |
| Authorized Official Name and Position | Ricardo Enrique Marana (PRESIDENT) |
| Authorized Official Contact | 2527533193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Farmville Internal Medicine Pa 3485 N Main St Farmville NC 27828-1466 Ph: (252) 753-3193 | Farmville Internal Medicine Pa 3485 N Main St Farmville NC 27828-1466 Ph: (252) 753-3193 |
| NPI Number | 1710942610 |
|---|---|
| Provider Enumeration Date | 04/20/2006 |
| Last Update Date | 04/20/2009 |
| Medicare PECOS PAC ID | 8325037575 |
|---|---|
| Medicare Enrollment ID | O20040511001545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710942610 | NPI | - | NPPES |
| 89126A3 | Medicaid | NC | |
| DF6187 | Other | NC | RAILROAD MEDICARE (GROUP NUMBER) |
| P00379704 | Other | NC | RAILROAD MEDICARE (PIN) |
| 126A3 | Other | NC | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20000090 (North Carolina) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 200000090 (North Carolina) | Secondary |
| Provider Name | Enrique V Marana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497717342 PECOS PAC ID: 2668461823 Enrollment ID: I20040511001627 |
| Provider Name | Debra Fell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326025610 PECOS PAC ID: 6305873654 Enrollment ID: I20050719000754 |
| Provider Name | Charlotte W Goodwyn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104170166 PECOS PAC ID: 8729231931 Enrollment ID: I20130118000325 |
| Provider Name | Kenneth Lovette |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811046535 PECOS PAC ID: 1355236340 Enrollment ID: I20170920002181 |
| Provider Name | Christina Kidd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306469549 PECOS PAC ID: 5698161404 Enrollment ID: I20220404002507 |
| Provider Name | Haley Dickerson Upchurch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598461386 PECOS PAC ID: 2163877655 Enrollment ID: I20231018004140 |
Physicians East Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3681 N Main St, Farmville, NC 27828 Phone: 252-753-7141 Fax: 252-753-5834 | |
Cvs Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4240 S Main St, Farmville, NC 27828 Phone: 252-753-2061 | |
Physicians East, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3681 N Main St, Suite 114, Farmville, NC 27828 Phone: 252-753-7141 Fax: 252-753-5834 |