| |
921 S Long Dr Suite 101 Rockingham NC 28379-4874 | |
(910) 417-3850 | |
(910) 417-3866 |
Full Name | |
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Speciality | Family Medicine |
Location | 921 S Long Dr, Rockingham, North Carolina |
Authorized Official Name and Position | Mickey Foster (CEO) |
Authorized Official Contact | 9107154473 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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921 S Long Dr Ste 101 Rockingham NC 28379-4874 Ph: (910) 417-3850 | 921 S Long Dr Suite 101 Rockingham NC 28379-4874 Ph: (910) 417-3850 |
NPI Number | 1720034895 |
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Provider Enumeration Date | 05/26/2006 |
Last Update Date | 01/06/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720034895 | NPI | - | NPPES |
1720034895 | Medicaid | NC | |
NPB223 | Medicaid | SC | |
0158J | Other | NC | BCBS |
02AY7 | Other | NC | BCBS |
CA6647 | Other | NC | RR MEDICARE |
89011HM | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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