| Group Service Inc | |
|
1503 Denim Dr Suite 101 Erwin NC 28339-3017 | |
| (919) 822-2172 | |
| Not Available |
| Full Name | Group Service Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1503 Denim Dr, Erwin, North Carolina |
| Authorized Official Name and Position | Antonio Fozard (CEO) |
| Authorized Official Contact | 9196976957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Group Service Inc Po Box 12821 Rtp NC 27709-2821 Ph: () - | Group Service Inc 1503 Denim Dr Suite 101 Erwin NC 28339-3017 Ph: (919) 822-2172 |
| NPI Number | 1144505504 |
|---|---|
| Provider Enumeration Date | 10/18/2011 |
| Last Update Date | 08/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144505504 | NPI | - | NPPES |
| 5918588 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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