| Healthserve North East | |
|
1439 E Cone Blvd Greensboro NC 27405-4533 | |
| (336) 375-6104 | |
| (336) 375-9308 |
| Full Name | Healthserve North East |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1439 E Cone Blvd, Greensboro, North Carolina |
| Authorized Official Name and Position | Brian K Ellerby (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3362721050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthserve North East 1046 E Wendover Ave Greensboro NC 27405-6712 Ph: (336) 272-1050 | Healthserve North East 1439 E Cone Blvd Greensboro NC 27405-4533 Ph: (336) 375-6104 |
| NPI Number | 1326348087 |
|---|---|
| Provider Enumeration Date | 10/28/2010 |
| Last Update Date | 08/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326348087 | NPI | - | NPPES |
| 2348638A | Other | NC | MEDICARE PART B |
| 34D0947992 | Other | CLIA | |
| 5916334 | Medicaid | NC | |
| 024TE | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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