| Live Well Primary Care Clinic | |
|
3901 N Roxboro St Ste 101 Durham NC 27704-2181 | |
| (919) 296-1758 | |
| Not Available |
| Full Name | Live Well Primary Care Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3901 N Roxboro St Ste 101, 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 |
|---|---|
| Live Well Primary Care Clinic Po Box 52119 Durham NC 27717-2119 Ph: (919) 956-4000 | Live Well Primary Care Clinic 3901 N Roxboro St Ste 101 Durham NC 27704-2181 Ph: (919) 296-1758 |
| NPI Number | 1801295936 |
|---|---|
| Provider Enumeration Date | 08/14/2014 |
| Last Update Date | 07/28/2022 |
| Medicare PECOS PAC ID | 4587642590 |
|---|---|
| Medicare Enrollment ID | O20150713003222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801295936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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