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330 Jake Alexander Blvd W Ste 102, 103 Salisbury NC 28147-1384 | |
(704) 519-2366 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 330 Jake Alexander Blvd W, Salisbury, North Carolina |
Authorized Official Name and Position | Don Holloman (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 7047922203 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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202d Mcgill Ave Nw Concord NC 28025-4615 Ph: (704) 792-2242 | 330 Jake Alexander Blvd W Ste 102, 103 Salisbury NC 28147-1384 Ph: (704) 519-2366 |
NPI Number | 1336780576 |
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Provider Enumeration Date | 09/30/2019 |
Last Update Date | 10/10/2023 |
Medicare PECOS PAC ID | 9638197635 |
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Medicare Enrollment ID | O20191113000346 |
Identifier | Type | State | Issuer |
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1336780576 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Copperfield Medical Center, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Mocksville Ave, Salisbury, NC 28144 Phone: 704-633-7220 Fax: 704-647-0515 | |