| Medstat Of Goldsboro Inc. | |
|
1707 Wayne Memorial Dr Goldsboro NC 27534-2239 | |
| (919) 736-9699 | |
| (919) 734-0501 |
| Full Name | Medstat Of Goldsboro Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1707 Wayne Memorial Dr, Goldsboro, North Carolina |
| Authorized Official Name and Position | Vicky B Le (ACCOUNT MANAGER) |
| Authorized Official Contact | 9197369699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medstat Of Goldsboro Inc. 1707 Wayne Memorial Dr Goldsboro NC 27534-2239 Ph: (919) 736-9699 | Medstat Of Goldsboro Inc. 1707 Wayne Memorial Dr Goldsboro NC 27534-2239 Ph: (919) 736-9699 |
| NPI Number | 1134217680 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 03/30/2010 |
| Medicare PECOS PAC ID | 5395871834 |
|---|---|
| Medicare Enrollment ID | O20100410000106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134217680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25354 (North Carolina) | Primary |
| Provider Name | Solange Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760568919 PECOS PAC ID: 5193036655 Enrollment ID: I20150624002363 |
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