| |
257 Hospital Dr. Suite 101 Bolivia NC 28422-8411 | |
(910) 721-4100 | |
(910) 721-4101 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 257 Hospital Dr. Suite 101, Bolivia, North Carolina |
Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
Authorized Official Contact | 7043166081 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 60447 Charlotte NC 28260-0447 Ph: (910) 721-4100 | 257 Hospital Dr. Suite 101 Bolivia NC 28422-8411 Ph: (910) 721-4100 |
NPI Number | 1265778278 |
---|---|
Provider Enumeration Date | 12/19/2012 |
Last Update Date | 07/09/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265778278 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Tri County Community Health Council Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4311 Old Ocean Highway, Bolivia, NC 28422 Phone: 877-935-5255 Fax: 910-236-2118 | |