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102 N Bond St Rowland NC 28383-9741 | |
(910) 422-3350 | |
(910) 422-3936 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 102 N Bond St, Rowland, North Carolina |
Authorized Official Name and Position | Charles Thomas Johnson (VICE PRESIDENT FINANCE) |
Authorized Official Contact | 9106715090 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2600 N Elm St Lumberton NC 28358-3011 Ph: (910) 272-3051 | 102 N Bond St Rowland NC 28383-9741 Ph: (910) 422-3350 |
NPI Number | 1891787503 |
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Provider Enumeration Date | 08/18/2005 |
Last Update Date | 01/24/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891787503 | NPI | - | NPPES |
0263J | Other | NC | BLUE CROSS BLUE SHIELD |
343417A | Medicaid | NC | |
343417C | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | H0064 (North Carolina) | Primary |
Procare Family Care Home Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2952 Alfordsville Road, Rowland, NC 28383 Phone: 910-422-9006 | |