Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 313 Main St, Bayboro, North Carolina |
Authorized Official Name and Position | Daphne Betts-hemby (CFO) |
Authorized Official Contact | 2527478162 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
7 Professional Dr Snow Hill NC 28580-1332 Ph: (252) 747-8162 | 313 Main St Bayboro NC 28515-0000 Ph: (252) 745-2070 |
NPI Number | 1619244084 |
---|---|
Provider Enumeration Date | 11/29/2011 |
Last Update Date | 01/16/2025 |
Medicare PECOS PAC ID | 0648189001 |
---|---|
Medicare Enrollment ID | O20111216000129 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619244084 | NPI | - | NPPES |
344050 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |