South Granville Primary Care | |
1614 Nc Highway 56 Creedmoor NC 27522-8297 | |
(919) 575-6103 | |
(919) 575-6817 |
Full Name | South Granville Primary Care |
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Speciality | Clinic/Center |
Location | 1614 Nc Highway 56, Creedmoor, North Carolina |
Authorized Official Name and Position | Jamie Purvis (CFO) |
Authorized Official Contact | 9196903237 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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South Granville Primary Care Po Box 986 Oxford NC 27565-0986 Ph: (919) 575-6103 | South Granville Primary Care 1614 Nc Highway 56 Creedmoor NC 27522-8297 Ph: (919) 575-6103 |
NPI Number | 1265430854 |
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Provider Enumeration Date | 07/08/2005 |
Last Update Date | 10/11/2024 |
Medicare PECOS PAC ID | 1052223757 |
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Medicare Enrollment ID | O20090427000061 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265430854 | NPI | - | NPPES |
344645A | Medicaid | NC | |
344645C | Medicaid | NC | |
02578 | Other | NC | BCBSNC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Duke Primary Care Butner-creedmor Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2503 E Lyon Station Rd, Creedmoor, NC 27522 Phone: 919-528-1535 |