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322 Main St Prospect Hill NC 27314-9438 | |
(336) 562-3311 | |
(336) 562-4444 |
Full Name | |
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Speciality | Clinic/Center |
Location | 322 Main St, Prospect Hill, North Carolina |
Authorized Official Name and Position | Brian Toomey (CEO) |
Authorized Official Contact | 9199338494 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 17179 Chapel Hill NC 27516-7179 Ph: (919) 933-8494 | 322 Main St Prospect Hill NC 27314-9438 Ph: (336) 562-3311 |
NPI Number | 1154425890 |
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Provider Enumeration Date | 09/12/2006 |
Last Update Date | 09/29/2015 |
Medicare PECOS PAC ID | 3476462102 |
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Medicare Enrollment ID | O20051021000853 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154425890 | NPI | - | NPPES |
344514 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |