| Guardian Hart Medical Care | |
|
1074 Southern Ave Fayetteville NC 28306 | |
| (910) 221-1590 | |
| (910) 221-1594 |
| Full Name | Guardian Hart Medical Care |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1074 Southern Ave, Fayetteville, North Carolina |
| Authorized Official Name and Position | Jonna Lynn Squires (INSURANCE BILLER) |
| Authorized Official Contact | 9102211590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Guardian Hart Medical Care 1074 Southern Avenue Fayetteville NC 28306 Ph: (910) 221-1590 | Guardian Hart Medical Care 1074 Southern Ave Fayetteville NC 28306 Ph: (910) 221-1590 |
| NPI Number | 1750490876 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 04/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750490876 | NPI | - | NPPES |
| 59-01572 | Medicaid | NC | |
| 014A1 | Other | NC | BCBS |
| 014A1 | Other | NC | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 128677 (North Carolina) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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