| Pine Haven Family Medicine Pa | |
|
604 West Academy St Randleman NC 27317 | |
| (336) 498-1200 | |
| (336) 498-1206 |
| Full Name | Pine Haven Family Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 604 West Academy St, Randleman, North Carolina |
| Authorized Official Name and Position | John James Slatosky (OWNER PHYSICIAN) |
| Authorized Official Contact | 3364981200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Haven Family Medicine Pa 604 West Academy St Randleman NC 27317 Ph: (336) 498-1200 | Pine Haven Family Medicine Pa 604 West Academy St Randleman NC 27317 Ph: (336) 498-1200 |
| NPI Number | 1891960241 |
|---|---|
| Provider Enumeration Date | 04/28/2008 |
| Last Update Date | 11/30/2012 |
| Medicare PECOS PAC ID | 2769409655 |
|---|---|
| Medicare Enrollment ID | O20051031000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891960241 | NPI | - | NPPES |
| 891212U | Medicaid | NC | |
| 2348546 | Other | NC | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9900682 (North Carolina) | Primary |
| Provider Name | John James Slatosky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982676441 PECOS PAC ID: 9133196215 Enrollment ID: I20040916001039 |
Randleman Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 670 W Academy St, Randleman, NC 27317 Phone: 336-498-8500 Fax: 336-498-8522 | |
Barn Door Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 807 High Point St Unit H, Randleman, NC 27317 Phone: 336-498-7777 Fax: 866-548-7001 | |
Randleman Medical Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 S Main St, Randleman, NC 27317 Phone: 336-498-8500 Fax: 336-498-8522 | |
Optimus Medical Center At Randleman Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 S Main St, Randleman, NC 27317 Phone: 336-545-1515 Fax: 336-545-4505 |