| Vita Family Practice Pllc | |
|
609 Executive Pl Ste B Fayetteville NC 28305-5713 | |
| (910) 489-3185 | |
| Not Available |
| Full Name | Vita Family Practice Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 609 Executive Pl Ste B, Fayetteville, North Carolina |
| Authorized Official Name and Position | Jennifer I Sturcken (OWNER) |
| Authorized Official Contact | 9106779488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vita Family Practice Pllc 609 Executive Pl Ste B Fayetteville NC 28305-5713 Ph: (910) 677-9488 | Vita Family Practice Pllc 609 Executive Pl Ste B Fayetteville NC 28305-5713 Ph: (910) 489-3185 |
| NPI Number | 1770004723 |
|---|---|
| Provider Enumeration Date | 06/29/2017 |
| Last Update Date | 01/31/2024 |
| Medicare PECOS PAC ID | 7911270442 |
|---|---|
| Medicare Enrollment ID | O20170906000747 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770004723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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