Hometown Direct Primary Care Pllc | |
332 N Brightleaf Blvd Ste C Smithfield NC 27577-4604 | |
(919) 901-7344 | |
(319) 250-7453 |
Full Name | Hometown Direct Primary Care Pllc |
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Speciality | Clinic/Center |
Location | 332 N Brightleaf Blvd Ste C, Smithfield, North Carolina |
Authorized Official Name and Position | Crystal B Rambeau (OWNER) |
Authorized Official Contact | 9199017344 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Hometown Direct Primary Care Pllc 3949 Chalybeate Springs Rd Fuquay Varina NC 27526-6207 Ph: (919) 910-7344 | Hometown Direct Primary Care Pllc 332 N Brightleaf Blvd Ste C Smithfield NC 27577-4604 Ph: (919) 901-7344 |
NPI Number | 1164042412 |
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Provider Enumeration Date | 04/16/2020 |
Last Update Date | 11/13/2020 |
Medicare PECOS PAC ID | 9638592686 |
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Medicare Enrollment ID | O20200708003652 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164042412 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Crystal B Rambeau |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518930783 PECOS PAC ID: 8820090004 Enrollment ID: I20070201000467 |
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