| |
7228 Moncure-pittsboro Road Moncure NC 27559-0980 | |
(919) 542-4991 | |
(919) 542-3726 |
Full Name | |
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Speciality | Clinic/Center |
Location | 7228 Moncure-pittsboro Road, Moncure, North Carolina |
Authorized Official Name and Position | Lydia F Mason (CFO) |
Authorized Official Contact | 9199338494 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 17179 Chapel Hill NC 27516-7179 Ph: (919) 933-8494 | 7228 Moncure-pittsboro Road Moncure NC 27559-0980 Ph: (919) 542-4991 |
NPI Number | 1871697599 |
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Provider Enumeration Date | 09/12/2006 |
Last Update Date | 06/12/2019 |
Medicare PECOS PAC ID | 3476462102 |
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Medicare Enrollment ID | O20051021000850 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871697599 | NPI | - | NPPES |
344513 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |