| Independence Medical, Pa | |
|
515 Barbour Rd Smithfield NC 27577-7698 | |
| (919) 544-4747 | |
| (919) 544-0104 |
| Full Name | Independence Medical, Pa |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 515 Barbour Rd, Smithfield, North Carolina |
| Authorized Official Name and Position | Bernard L Bennett (PRESIDENT) |
| Authorized Official Contact | 9196228272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Medical, Pa 1209 Falls Bridge Dr Raleigh NC 27614-8935 Ph: (919) 544-4747 | Independence Medical, Pa 515 Barbour Rd Smithfield NC 27577-7698 Ph: (919) 544-4747 |
| NPI Number | 1700845112 |
|---|---|
| Provider Enumeration Date | 03/23/2006 |
| Last Update Date | 10/31/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700845112 | NPI | - | NPPES |
| DA5493 | Other | NC | MEDICARE RAILROAD |
| 891028P | Medicaid | NC | |
| 1028P | Medicaid | NC | |
| P00062870 | Other | NC | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 36493 (North Carolina) | Primary |
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Independence Health Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 Barbour Rd, Smithfield, NC 27577 Phone: 919-934-6017 Fax: 919-934-2057 | |
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