| Nova Ic, Inc. | |
|
2307 Norwood Ave Ste A Goldsboro NC 27534-1601 | |
| (919) 735-8887 | |
| (919) 735-8871 |
| Full Name | Nova Ic, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2307 Norwood Ave Ste A, Goldsboro, North Carolina |
| Authorized Official Name and Position | Tracey Pridgen (CFO) |
| Authorized Official Contact | 9197348803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Ic, Inc. Po Box 11077 Goldsboro NC 27532-1077 Ph: (919) 734-8803 | Nova Ic, Inc. 2307 Norwood Ave Ste A Goldsboro NC 27534-1601 Ph: (919) 735-8887 |
| NPI Number | 1053634824 |
|---|---|
| Provider Enumeration Date | 03/09/2010 |
| Last Update Date | 09/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053634824 | NPI | - | NPPES |
| 3406164 | Medicaid | NC | |
| 340608V | Medicaid | NC | |
| 3406058 | Medicaid | NC | |
| 340610M | Medicaid | NC | |
| 8302565 | Medicaid | NC | |
| 6006439 | Medicaid | NC | |
| 3406289 | Medicaid | NC | |
| 3406312 | Medicaid | NC | |
| 340609R | Medicaid | NC | |
| 3406174 | Medicaid | NC | |
| 8302772 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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