Full Name | |
---|---|
Speciality | Internal Medicine - Gastroenterology |
Location | 102 Endo Ln, Hamlet, North Carolina |
Authorized Official Name and Position | Patricia J Riddle (OFFICE MGR ADMINISTRATOR) |
Authorized Official Contact | 8434799794 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 617 Bennettsville SC 29512-0617 Ph: (843) 479-6268 | 102 Endo Ln Hamlet NC 28345-4560 Ph: (910) 205-3035 |
NPI Number | 1922077403 |
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Provider Enumeration Date | 03/16/2006 |
Last Update Date | 05/19/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922077403 | NPI | - | NPPES |
0191F | Other | NC | BCBS GROUP |
PC1896 | Medicaid | SC | |
DE8861 | Other | SC | SC RR MEDICARE GROUP |
890191F | Medicaid | NC | |
CF8544 | Other | NC | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | 10779 (South Carolina) | Secondary |
207RG0100X | Internal Medicine - Gastroenterology | 27767 (North Carolina) | Primary |
Tarheel Family Medicine Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 224 W Main St, Ste A, Hamlet, NC 28345 Phone: 910-582-2696 Fax: 910-582-2640 |