| Cape Fear Valley Bma Elizabethtown | |
|
300a E Mckay St Elizabethtown NC 28337-9037 | |
| (910) 862-5500 | |
| (910) 862-5501 |
| Full Name | Cape Fear Valley Bma Elizabethtown |
|---|---|
| Speciality | Clinic/Center |
| Location | 300a E Mckay St, Elizabethtown, North Carolina |
| Authorized Official Name and Position | Joseph B Fiser (VP MANAGED CARE AND REVENUE CYCLE) |
| Authorized Official Contact | 9106155572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cape Fear Valley Bma Elizabethtown 300-a East Mckay Street Elizabethtown NC 28337 Ph: (910) 862-6308 | Cape Fear Valley Bma Elizabethtown 300a E Mckay St Elizabethtown NC 28337-9037 Ph: (910) 862-5500 |
| NPI Number | 1255507737 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 01/20/2024 |
| Medicare PECOS PAC ID | 6800967969 |
|---|---|
| Medicare Enrollment ID | O20121215000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255507737 | NPI | - | NPPES |
| 34-3966A | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | H0154 (North Carolina) | Primary |
| Provider Name | Olajumoke Ladapo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033746292 PECOS PAC ID: 1456796507 Enrollment ID: I20240228001777 |
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