|
| |
|
5009 Fallston Rd Lawndale NC 28090-9585 | |
| (704) 538-8532 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 5009 Fallston Rd, Lawndale, North Carolina |
| Authorized Official Name and Position | Sharmila Alexander Anderson (MEDICAL BILLING & CODING SUPERVISOR) |
| Authorized Official Contact | 7048741907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
200 E 2nd Ave Gastonia NC 28052-4358 Ph: () - | 5009 Fallston Rd Lawndale NC 28090-9585 Ph: (704) 538-8532 |
| NPI Number | 1043963564 |
|---|---|
| Provider Enumeration Date | 02/03/2022 |
| Last Update Date | 02/16/2022 |
| Medicare PECOS PAC ID | 5496733925 |
|---|---|
| Medicare Enrollment ID | O20220516000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043963564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Gaston Family Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 Shady Grove Rd, Lawndale, NC 28090 Phone: 704-476-8223 Fax: 704-538-3944 |