| Kintegra Family Medicine - 3rd Ave | |
|
111 E 3rd Ave Gastonia NC 28052-4343 | |
| (704) 874-3300 | |
| (704) 874-0065 |
| Full Name | Kintegra Family Medicine - 3rd Ave |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 E 3rd Ave, Gastonia, North Carolina |
| Authorized Official Name and Position | Sharmila Alexander Anderson (BUSINESS SERVICE ADMINISTRATOR) |
| Authorized Official Contact | 7048741907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kintegra Family Medicine - 3rd Ave 200 E 2nd Ave Gastonia NC 28052-4358 Ph: (704) 871-1904 | Kintegra Family Medicine - 3rd Ave 111 E 3rd Ave Gastonia NC 28052-4343 Ph: (704) 874-3300 |
| NPI Number | 1548389125 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 07/28/2020 |
| Medicare PECOS PAC ID | 5496733925 |
|---|---|
| Medicare Enrollment ID | O20080528000103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548389125 | NPI | - | NPPES |
| 34D1048048 | Other | NC | CLIA WAIVER |
| 0136X | Other | NC | BLUE CROSS NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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