| |
355 S Madison Blvd Ste A Roxboro NC 27573-5485 | |
(336) 597-2204 | |
(336) 597-4804 |
Full Name | |
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Speciality | Clinic/Center |
Location | 355 S Madison Blvd, Roxboro, North Carolina |
Authorized Official Name and Position | Janet O Clayton (HEALTH DIRECTOR) |
Authorized Official Contact | 3365972204 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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355 S Madison Blvd Ste A Roxboro NC 27573-5485 Ph: (336) 597-2204 | 355 S Madison Blvd Ste A Roxboro NC 27573-5485 Ph: (336) 597-2204 |
NPI Number | 1427125616 |
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Provider Enumeration Date | 11/30/2006 |
Last Update Date | 10/19/2007 |
Medicare PECOS PAC ID | 6800986001 |
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Medicare Enrollment ID | O20080124000140 |
Identifier | Type | State | Issuer |
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1427125616 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Primary |
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