| |
801 Tilghman Dr Ste A Dunn NC 28334-4958 | |
(910) 892-6500 | |
(910) 302-5897 |
Full Name | |
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Speciality | Clinic/Center |
Location | 801 Tilghman Dr Ste A, Dunn, North Carolina |
Authorized Official Name and Position | Greg Bounds (CEO) |
Authorized Official Contact | 9102672042 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 187 Faison NC 28341-0187 Ph: (910) 267-2042 | 801 Tilghman Dr Ste A Dunn NC 28334-4958 Ph: (910) 892-6500 |
NPI Number | 1780193557 |
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Provider Enumeration Date | 09/25/2017 |
Last Update Date | 12/16/2024 |
Medicare PECOS PAC ID | 3173434479 |
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Medicare Enrollment ID | O20171220002667 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780193557 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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