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119 Crossover Rd Beulaville NC 28518-8801 | |
| (910) 298-3125 | |
| (910) 267-8980 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 119 Crossover Rd, Beulaville, North Carolina |
| Authorized Official Name and Position | Rebecca M. Brown (CREDENTIALING) |
| Authorized Official Contact | 9102678252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 187 Faison NC 28341-0187 Ph: (910) 267-0421 | 119 Crossover Rd Beulaville NC 28518-8801 Ph: (910) 298-3125 |
| NPI Number | 1639294309 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 03/02/2015 |
| Medicare PECOS PAC ID | 3173434479 |
|---|---|
| Medicare Enrollment ID | O20030908000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639294309 | NPI | - | NPPES |
| 344595A | Medicaid | NC | |
| 014VE | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Physicians East, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 152 Crossover Rd, Beulaville, NC 28518 Phone: 910-298-4688 Fax: 910-298-4628 | |
Carawan Health Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 E Park Dr, Beulaville, NC 28518 Phone: 910-777-5888 Fax: 910-226-6131 |