| |
1 Trade St Granite Falls NC 28630-1525 | |
(828) 396-3136 | |
(828) 396-3105 |
Full Name | |
---|---|
Speciality | Clinic/center |
Location | 1 Trade St, Granite Falls, North Carolina |
Authorized Official Name and Position | Karen A. Stewart (ADMINISTRATIVE ASSISTANT) |
Authorized Official Contact | 8284659730 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
One Trade Street Granite Falls NC 28630 Ph: (828) 396-3136 | 1 Trade St Granite Falls NC 28630-1525 Ph: (828) 396-3136 |
NPI Number | 1265516520 |
---|---|
Provider Enumeration Date | 10/24/2006 |
Last Update Date | 12/20/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265516520 | NPI | - | NPPES |
CN8132 | Other | NC | MEDICARE RAILROAD |
CN8132 | Other | NC | RAILROAD MEDICARE |
790148F | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (North Carolina) | Primary |