| Providence Family Practice Associates Pa | |
|
1043 Marguerite Drive Lowell NC 28098 | |
| (704) 478-6169 | |
| (704) 478-6169 |
| Full Name | Providence Family Practice Associates Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1043 Marguerite Drive, Lowell, North Carolina |
| Authorized Official Name and Position | Tilda Abernathy Jones (PRACTICE MANAGER) |
| Authorized Official Contact | 7044786169 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Family Practice Associates Pa 1043 Marguerite Drive Lowell NC 28098 Ph: (704) 478-6169 | Providence Family Practice Associates Pa 1043 Marguerite Drive Lowell NC 28098 Ph: (704) 478-6169 |
| NPI Number | 1528090388 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528090388 | NPI | - | NPPES |
| 890178L | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9501625 (North Carolina) | Primary |
Gaston Family Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 418 S Church St, Lowell, NC 28098 Phone: 704-836-9607 Fax: 704-824-4529 |