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795 Us Highway 64 E Plymouth NC 27962-9314 | |
(252) 793-4500 | |
(252) 793-7336 |
Full Name | |
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Speciality | Clinic/Center |
Location | 795 Us Highway 64 E, Plymouth, North Carolina |
Authorized Official Name and Position | Frank T Avignone (CEO) |
Authorized Official Contact | 2145029624 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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7920 Belt Line Rd Ste 215 Dallas TX 75254-8155 Ph: (214) 210-9095 | 795 Us Highway 64 E Plymouth NC 27962-9314 Ph: (252) 793-4500 |
NPI Number | 1811502818 |
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Provider Enumeration Date | 09/15/2020 |
Last Update Date | 06/17/2022 |
Medicare PECOS PAC ID | 3779993837 |
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Medicare Enrollment ID | O20201110001037 |
Identifier | Type | State | Issuer |
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1811502818 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Martin Tyrrell Washington District Health Dept Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 198 Nc Highway 45 N, Plymouth, NC 27962 Phone: 252-791-3119 Fax: 252-791-3159 | |