| Goshen Medical Center - New River | |
|
1200 Hargett St Jacksonville NC 28540-5933 | |
| (910) 219-1082 | |
| (910) 219-1087 |
| Full Name | Goshen Medical Center - New River |
|---|---|
| Speciality | Clinic/Center |
| Location | 1200 Hargett St, Jacksonville, North Carolina |
| Authorized Official Name and Position | Reba W. Futrell (EXECUTIVE ASSISTANT/CREDENTIALING) |
| Authorized Official Contact | 9102678252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goshen Medical Center - New River 444 Sw Center St Faison NC 28341-8820 Ph: (910) 267-0421 | Goshen Medical Center - New River 1200 Hargett St Jacksonville NC 28540-5933 Ph: (910) 219-1082 |
| NPI Number | 1669797700 |
|---|---|
| Provider Enumeration Date | 04/01/2010 |
| Last Update Date | 01/23/2012 |
| Medicare PECOS PAC ID | 3173434479 |
|---|---|
| Medicare Enrollment ID | O20120305000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669797700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
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