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906 Us Highway 421 Clinton NC 28328-0410 | |
(910) 592-1462 | |
(919) 364-8367 |
Full Name | |
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Speciality | Clinic/Center |
Location | 906 Us Highway 421, Clinton, North Carolina |
Authorized Official Name and Position | Gregory M Bounds (CEO) |
Authorized Official Contact | 9102671237 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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412 Sw Center Street Faison NC 28341-0187 Ph: (910) 267-1942 | 906 Us Highway 421 Clinton NC 28328-0410 Ph: (910) 592-1462 |
NPI Number | 1073638557 |
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Provider Enumeration Date | 03/21/2007 |
Last Update Date | 10/06/2021 |
Medicare PECOS PAC ID | 3173434479 |
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Medicare Enrollment ID | O20040116000690 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073638557 | NPI | - | NPPES |
344596A | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
Sampson Regional Professional Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 607 Beaman St, Clinton, NC 28328 Phone: 910-592-8511 Fax: 910-596-5430 | |
Total Health Internal Medicine, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 602 Beaman St, Unit 606, Clinton, NC 28328 Phone: 910-596-0061 Fax: 910-596-0062 |