Mountain Family Care Center | |
200 Hospital Ave Jefferson NC 28640-9244 | |
(336) 846-6322 | |
(336) 846-1702 |
Full Name | Mountain Family Care Center |
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Speciality | Clinic/Center |
Location | 200 Hospital Ave, Jefferson, North Carolina |
Authorized Official Name and Position | Laura Lambeth (CEO) |
Authorized Official Contact | 3368460790 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mountain Family Care Center 200 Hospital Ave Jefferson NC 28640-9244 Ph: (336) 846-6322 | Mountain Family Care Center 200 Hospital Ave Jefferson NC 28640-9244 Ph: (336) 846-6322 |
NPI Number | 1427048172 |
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Provider Enumeration Date | 10/25/2005 |
Last Update Date | 08/10/2015 |
Medicare PECOS PAC ID | 7315912870 |
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Medicare Enrollment ID | O20041221000034 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427048172 | NPI | - | NPPES |
343425C | Medicaid | NC | |
016TY | Other | NC | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Kathleen G Miller |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487022372 PECOS PAC ID: 0446532022 Enrollment ID: I20181129000811 |
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