| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 57635 Hwy 12, Hatteras, North Carolina |
| Authorized Official Name and Position | Lynn T. Lanier (VP OF FINANCE FOR EAST CAROLINA HEA) |
| Authorized Official Contact | 2528477479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
57635 Hwy 12 Hatteras NC 27943 Ph: (252) 986-2756 | 57635 Hwy 12 Hatteras NC 27943 Ph: (252) 986-2756 |
| NPI Number | 1336101369 |
|---|---|
| Provider Enumeration Date | 04/05/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336101369 | NPI | - | NPPES |
| 0290U | Other | NC | BCBS # |
| 790155C | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (North Carolina) | Primary |
Hatteras Village Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 57635 Hwy 12, Hatteras, NC 27943 Phone: 252-928-1511 Fax: 252-928-7391 |