| Granville Internal Medicine & Geriatrics | |
|
110 Professional Park Drive Oxford NC 27565-2756 | |
| (919) 693-6541 | |
| (919) 693-7396 |
| Full Name | Granville Internal Medicine & Geriatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 Professional Park Drive, Oxford, North Carolina |
| Authorized Official Name and Position | Jamie Purvis (CFO) |
| Authorized Official Contact | 9196903237 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Granville Internal Medicine & Geriatrics Po Box 986 Oxford NC 27565-0986 Ph: (919) 693-6541 | Granville Internal Medicine & Geriatrics 110 Professional Park Drive Oxford NC 27565-2756 Ph: (919) 693-6541 |
| NPI Number | 1811999055 |
|---|---|
| Provider Enumeration Date | 06/01/2005 |
| Last Update Date | 10/11/2024 |
| Medicare PECOS PAC ID | 1052223757 |
|---|---|
| Medicare Enrollment ID | O20100304000720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811999055 | NPI | - | NPPES |
| 344646C | Medicaid | NC | |
| 014WA | Other | NC | BCBS |
| 022FT | Other | NC | BCBS |
| 344646A | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (North Carolina) | Primary |
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