| |
201 Highway 321 S Dallas NC 28034-1402 | |
(704) 922-6200 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 201 Highway 321 S, Dallas, North Carolina |
Authorized Official Name and Position | Sharmila Alexander Anderson (MEDICAL BILLING & CODING SUPERVISOR) |
Authorized Official Contact | 7048741907 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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200 E 2nd Ave Gastonia NC 28052-4358 Ph: () - | 201 Highway 321 S Dallas NC 28034-1402 Ph: (704) 922-6200 |
NPI Number | 1023689304 |
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Provider Enumeration Date | 07/07/2021 |
Last Update Date | 07/09/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023689304 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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