| |
270 Smith Church Rd Roanoke Rapids NC 27870-4914 | |
(252) 537-0134 | |
(252) 537-6515 |
Full Name | |
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Speciality | Clinic/Center |
Location | 270 Smith Church Rd, Roanoke Rapids, North Carolina |
Authorized Official Name and Position | Judy Belch Beasley (DIRECTOR OF REVENUE) |
Authorized Official Contact | 2525365791 |
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) 536-5791 | 270 Smith Church Rd Roanoke Rapids NC 27870-4914 Ph: (252) 537-0134 |
NPI Number | 1598253734 |
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Provider Enumeration Date | 04/24/2018 |
Last Update Date | 04/24/2018 |
Medicare PECOS PAC ID | 9739090226 |
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Medicare Enrollment ID | O20180725002455 |
Identifier | Type | State | Issuer |
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1598253734 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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