| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 217 N Main St., Grover, North Carolina |
| Authorized Official Name and Position | Daniel L Wiens (SENIOR VICE PRESIDENT) |
| Authorized Official Contact | 7043550648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5000 Airport Center Pkwy Ste A Charlotte NC 28208-5899 Ph: (704) 512-4116 | 217 N Main St. Grover NC 28073 Ph: (704) 937-7905 |
| NPI Number | 1740210897 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740210897 | NPI | - | NPPES |
| 89015J4 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Gaston Family Health Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 Carolina Ave, Grover, NC 28073 Phone: 704-476-8351 Fax: 704-734-5616 |