Health Pavilion Family Care | |
6387 Ramsey St Unit 210 Fayetteville NC 28311-9442 | |
(910) 615-3920 | |
(910) 321-6221 |
Full Name | Health Pavilion Family Care |
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Speciality | Family Medicine |
Location | 6387 Ramsey St Unit 210, Fayetteville, North Carolina |
Authorized Official Name and Position | Joseph Fiser (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9106155572 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Health Pavilion Family Care 1638 Owen Drive Attn: Managed Care Planning Fayetteville NC 28304 Ph: (910) 615-6949 | Health Pavilion Family Care 6387 Ramsey St Unit 210 Fayetteville NC 28311-9442 Ph: (910) 615-3920 |
NPI Number | 1003818485 |
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Provider Enumeration Date | 08/15/2005 |
Last Update Date | 01/19/2024 |
Medicare PECOS PAC ID | 5193784494 |
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Medicare Enrollment ID | O20041004000352 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003818485 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Godfrey E Ohadugha |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902809510 PECOS PAC ID: 6901896265 Enrollment ID: I20040517001588 |
Provider Name | Jamila Devora Rouse |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083245476 PECOS PAC ID: 4981035656 Enrollment ID: I20200513000566 |
Provider Name | April Adams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750810859 PECOS PAC ID: 6002176427 Enrollment ID: I20200820002590 |
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