| |
103 Stanly Pkwy Suite A Locust NC 28097-7710 | |
(704) 888-0580 | |
(704) 888-0602 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 103 Stanly Pkwy, Locust, North Carolina |
Authorized Official Name and Position | Marindy Bost Harris (MANAGER REVENUE CYCLE) |
Authorized Official Contact | 7049837320 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
320 Yadkin St Ste B Albemarle NC 28001-3447 Ph: (704) 983-7320 | 103 Stanly Pkwy Suite A Locust NC 28097-7710 Ph: (704) 888-0580 |
NPI Number | 1871574921 |
---|---|
Provider Enumeration Date | 11/07/2005 |
Last Update Date | 07/15/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871574921 | NPI | - | NPPES |
890229J | Medicaid | NC | |
0229J | Other | NC | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |