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106 Se Railroad Street Whitakers NC 27891-8897 | |
(252) 536-5440 | |
(252) 536-5444 |
Full Name | |
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Speciality | Clinic/Center |
Location | 106 Se Railroad Street, Whitakers, North Carolina |
Authorized Official Name and Position | Brian O. Harris (CEO) |
Authorized Official Contact | 2525365440 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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106 Se Railroad Street Whitakers NC 27891-8897 Ph: (252) 536-5440 | 106 Se Railroad Street Whitakers NC 27891-8897 Ph: (252) 536-5440 |
NPI Number | 1013157171 |
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Provider Enumeration Date | 03/03/2009 |
Last Update Date | 03/03/2009 |
Medicare PECOS PAC ID | 9739090226 |
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Medicare Enrollment ID | O20090325000227 |
Identifier | Type | State | Issuer |
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1013157171 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |