| |
1688 E Arlington Blvd Greenville NC 27858-5871 | |
(252) 353-1464 | |
(252) 353-1272 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1688 E Arlington Blvd, Greenville, North Carolina |
Authorized Official Name and Position | Joyce Smith (BUSINESS MANAGER) |
Authorized Official Contact | 2523531464 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1688 E Arlington Blvd Greenville NC 27858-5871 Ph: (252) 353-1464 | 1688 E Arlington Blvd Greenville NC 27858-5871 Ph: (252) 353-1464 |
NPI Number | 1336268937 |
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Provider Enumeration Date | 03/28/2007 |
Last Update Date | 06/18/2008 |
Medicare PECOS PAC ID | 8123276003 |
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Medicare Enrollment ID | O20120918000786 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336268937 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 39329 (North Carolina) | Primary |
Provider Name | Teresa Smith |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1275521973 PECOS PAC ID: 1759538762 Enrollment ID: I20120827000695 |
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