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1006 Us Highway 64 E Plymouth NC 27962 | |
(252) 793-7701 | |
(252) 793-7736 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 1006 Us Highway 64 E, Plymouth, North Carolina |
Authorized Official Name and Position | Frank Titus Avignone (CEO) |
Authorized Official Contact | 2145029624 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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7920 Belt Line Rd Ste 215 Dallas TX 75254-8155 Ph: (214) 502-9624 | 1006 Us Highway 64 E Plymouth NC 27962 Ph: (252) 793-7701 |
NPI Number | 1962650762 |
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Provider Enumeration Date | 09/04/2008 |
Last Update Date | 05/11/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962650762 | NPI | - | NPPES |
343430A&C | Medicaid | NC | |
890233W | Other | NC | CAROLINA ACCESS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | H0006 (North Carolina) | Primary |
Martin Tyrrell Washington District Health Dept Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 198 Nc Highway 45 N, Plymouth, NC 27962 Phone: 252-791-3119 Fax: 252-791-3159 | |