| Ant Mary's Family Care #1 | |
|
104 West James Street Ant Mary's Family Care Home #1 Lagrange NC 28551-3770 | |
| (919) 344-9903 | |
| Not Available |
| Full Name | Ant Mary's Family Care #1 |
|---|---|
| Speciality | Clinic/center |
| Location | 104 West James Street, Lagrange, North Carolina |
| Authorized Official Name and Position | Eula Conyers (OWNER) |
| Authorized Official Contact | 9193449903 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ant Mary's Family Care #1 104 West James St. Ant Mary's Family Care Home #1 Lagrange NC 28551-3770 Ph: (919) 344-9903 | Ant Mary's Family Care #1 104 West James Street Ant Mary's Family Care Home #1 Lagrange NC 28551-3770 Ph: (919) 344-9903 |
| NPI Number | 1760709364 |
|---|---|
| Provider Enumeration Date | 04/23/2010 |
| Last Update Date | 05/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760709364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | FCL054065 (North Carolina) | Primary |
Goldsboro Pediatrics Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 E Railroad Street, Lagrange, NC 28551 Phone: 252-566-5999 Fax: 252-566-4430 |