| Gaston Family Care, P.a. | |
|
1381 E Garrison Blvd Gastonia NC 28054-5127 | |
| (704) 861-2273 | |
| (704) 864-6336 |
| Full Name | Gaston Family Care, P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1381 E Garrison Blvd, Gastonia, North Carolina |
| Authorized Official Name and Position | Gary Scott Schenk (OWNER) |
| Authorized Official Contact | 7048612273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaston Family Care, P.a. 1381 E Garrison Blvd Gastonia NC 28054-5127 Ph: (704) 861-2273 | Gaston Family Care, P.a. 1381 E Garrison Blvd Gastonia NC 28054-5127 Ph: (704) 861-2273 |
| NPI Number | 1316269806 |
|---|---|
| Provider Enumeration Date | 02/24/2010 |
| Last Update Date | 11/02/2010 |
| Medicare PECOS PAC ID | 0042404600 |
|---|---|
| Medicare Enrollment ID | O20101028000323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316269806 | NPI | - | NPPES |
| 897479B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 34155 (North Carolina) | Primary |
| Provider Name | Gary S Schenk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417021254 PECOS PAC ID: 5890987051 Enrollment ID: I20101006000196 |
| Provider Name | Logan Ballard Harley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265047476 PECOS PAC ID: 9133531239 Enrollment ID: I20201215000426 |
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