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307 S. Main Street Lewiston NC 27849-9694 | |
(252) 348-2545 | |
(252) 348-2239 |
Full Name | |
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Speciality | Clinic/Center |
Location | 307 S. Main Street, Lewiston, North Carolina |
Authorized Official Name and Position | Sharonda Pugh (CEO) |
Authorized Official Contact | 2527941835 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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P.o. Box 39 Lewiston NC 27849-0039 Ph: (252) 348-2545 | 307 S. Main Street Lewiston NC 27849-9694 Ph: (252) 348-2545 |
NPI Number | 1841541877 |
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Provider Enumeration Date | 10/01/2012 |
Last Update Date | 10/01/2012 |
Medicare PECOS PAC ID | 8325949167 |
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Medicare Enrollment ID | O20120716000303 |
Identifier | Type | State | Issuer |
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1841541877 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |