| |
712 Fleming St Hendersonville NC 28791-3502 | |
(828) 694-7630 | |
(828) 694-7631 |
Full Name | |
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Speciality | Clinic/Center |
Location | 712 Fleming St, Hendersonville, North Carolina |
Authorized Official Name and Position | Michael Lynn Sunday (VP, CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8286961175 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5221 Paramount Pkwy Ste 440 Morrisville NC 27560-5491 Ph: (984) 974-1190 | 712 Fleming St Hendersonville NC 28791-3502 Ph: (828) 694-7630 |
NPI Number | 1518696236 |
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Provider Enumeration Date | 06/08/2022 |
Last Update Date | 05/11/2023 |
Medicare PECOS PAC ID | 8123938115 |
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Medicare Enrollment ID | O20221025001078 |
Identifier | Type | State | Issuer |
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1518696236 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
Primedoc Park Ridge Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Hospital Dr, Hendersonville, NC 28792 Phone: 843-237-3378 Fax: 843-237-5073 | |
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