Mideastern Telemedicine | |
117 Salem Towne Ct Apex NC 27502-2311 | |
(919) 867-1937 | |
(919) 551-7510 |
Full Name | Mideastern Telemedicine |
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Speciality | Nurse Practitioner |
Location | 117 Salem Towne Ct, Apex, North Carolina |
Authorized Official Name and Position | Ursula Tomika White (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 9198671937 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mideastern Telemedicine 2053 Crampton Grove Way Cary NC 27519-8766 Ph: (919) 867-1937 | Mideastern Telemedicine 117 Salem Towne Ct Apex NC 27502-2311 Ph: (919) 867-1937 |
NPI Number | 1407482912 |
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Provider Enumeration Date | 03/16/2020 |
Last Update Date | 09/21/2024 |
Medicare PECOS PAC ID | 3678995347 |
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Medicare Enrollment ID | O20200625001566 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407482912 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Provider Name | Ursula Tomika White |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912224726 PECOS PAC ID: 5395174759 Enrollment ID: I20200406002182 |
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