| Wade Family Medical Center Adult Health | |
|
1235 Ramsey St Ste B Fayetteville NC 28301-4401 | |
| (910) 433-3770 | |
| (910) 307-3951 |
| Full Name | Wade Family Medical Center Adult Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 1235 Ramsey St Ste B, Fayetteville, North Carolina |
| Authorized Official Name and Position | Melva Leonor Jackson (PROGRAM SUPPORT) |
| Authorized Official Contact | 9104836694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wade Family Medical Center Adult Health Po Box 449 Wade NC 28395-0449 Ph: (910) 483-6694 | Wade Family Medical Center Adult Health 1235 Ramsey St Ste B Fayetteville NC 28301-4401 Ph: (910) 433-3770 |
| NPI Number | 1912639808 |
|---|---|
| Provider Enumeration Date | 06/29/2022 |
| Last Update Date | 05/04/2023 |
| Medicare PECOS PAC ID | 0042205189 |
|---|---|
| Medicare Enrollment ID | O20221209000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912639808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Tandeka N Burks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689675001 PECOS PAC ID: 3274564075 Enrollment ID: I20050822000784 |
| Provider Name | Sandra M Carr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114085354 PECOS PAC ID: 6901946052 Enrollment ID: I20091221000446 |
| Provider Name | Anna Watkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245627264 PECOS PAC ID: 2860746120 Enrollment ID: I20181126003494 |
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