| |
222 S Main St Red Springs NC 28377-1622 | |
(910) 843-4576 | |
(910) 843-2301 |
Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 222 S Main St, Red Springs, North Carolina |
Authorized Official Name and Position | Charles Thomas Johnson (CFO) |
Authorized Official Contact | 9106715090 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
2600 N Elm St Lumberton NC 28358-3011 Ph: (910) 272-3051 | 222 S Main St Red Springs NC 28377-1622 Ph: (910) 843-4576 |
NPI Number | 1972595601 |
---|---|
Provider Enumeration Date | 08/18/2005 |
Last Update Date | 01/27/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972595601 | NPI | - | NPPES |
343415C | Medicaid | NC | |
343415A | Medicaid | NC | |
0185K | Other | NC | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | H0064 (North Carolina) | Primary |
Red Springs Family Medicine Clinic, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 S Main St, Red Springs, NC 28377 Phone: 910-843-9991 Fax: 910-843-9995 | |