| John H Lucas Sr Wellness Center | |
|
3727 Fayetteville St Durham NC 27707-4718 | |
| (919) 956-4519 | |
| (919) 688-3288 |
| Full Name | John H Lucas Sr Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3727 Fayetteville St, Durham, North Carolina |
| Authorized Official Name and Position | Claretta Foye (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9199564022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John H Lucas Sr Wellness Center Po Box 52119 Durham NC 27717-2119 Ph: (919) 956-4000 | John H Lucas Sr Wellness Center 3727 Fayetteville St Durham NC 27707-4718 Ph: (919) 956-4519 |
| NPI Number | 1649210279 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 07/28/2022 |
| Medicare PECOS PAC ID | 4587642590 |
|---|---|
| Medicare Enrollment ID | O20041101000593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649210279 | NPI | - | NPPES |
| 344500A | Medicaid | NC | |
| 03055 | Other | NC | NC BC/BS ID NUMBER |
| 344500C | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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