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217 W Broad St Saint Pauls NC 28384-1533 | |
(910) 241-3078 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 217 W Broad St, Saint Pauls, North Carolina |
Authorized Official Name and Position | Ella Hunt (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 9107373147 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2002 N Cedar St Ste B Lumberton NC 28358-3926 Ph: (910) 272-3048 | 217 W Broad St Saint Pauls NC 28384-1533 Ph: (910) 241-3078 |
NPI Number | 1487113668 |
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Provider Enumeration Date | 03/18/2019 |
Last Update Date | 10/08/2020 |
Identifier | Type | State | Issuer |
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1487113668 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |