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114 Market St Enfield NC 27823-1423 | |
(252) 445-2332 | |
(252) 445-2983 |
Full Name | |
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Speciality | Clinic/Center |
Location | 114 Market St, Enfield, North Carolina |
Authorized Official Name and Position | Brian O. Harris (CEO) |
Authorized Official Contact | 2525365929 |
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 640 Roanoke Rapids NC 27870-0640 Ph: (252) 536-5440 | 114 Market St Enfield NC 27823-1423 Ph: (252) 445-2332 |
NPI Number | 1952665929 |
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Provider Enumeration Date | 06/25/2012 |
Last Update Date | 01/16/2013 |
Medicare PECOS PAC ID | 9739090226 |
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Medicare Enrollment ID | O20120821000758 |
Identifier | Type | State | Issuer |
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1952665929 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |