| Goshen Medical Center Incorporated | |
|
4654 Long Beach Rd Se Southport NC 28461-8799 | |
| (910) 457-0070 | |
| Not Available |
| Full Name | Goshen Medical Center Incorporated |
|---|---|
| Speciality | Clinic/Center |
| Location | 4654 Long Beach Rd Se, Southport, North Carolina |
| Authorized Official Name and Position | Greg Bounds (CEO) |
| Authorized Official Contact | 9102671942 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goshen Medical Center Incorporated 444 Sw Center St Faison NC 28341-8820 Ph: (910) 267-0421 | Goshen Medical Center Incorporated 4654 Long Beach Rd Se Southport NC 28461-8799 Ph: (910) 457-0070 |
| NPI Number | 1548711963 |
|---|---|
| Provider Enumeration Date | 10/20/2016 |
| Last Update Date | 05/29/2019 |
| Medicare PECOS PAC ID | 3173434479 |
|---|---|
| Medicare Enrollment ID | O20170203002345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548711963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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