| Triad Adult And Pediatric Medicine, Inc. | |
|
1002 S Eugene St Greensboro NC 27406-1308 | |
| (336) 355-9701 | |
| (336) 763-2896 |
| Full Name | Triad Adult And Pediatric Medicine, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1002 S Eugene St, Greensboro, North Carolina |
| Authorized Official Name and Position | Brian K. Ellerby (CEO) |
| Authorized Official Contact | 3363559696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Triad Adult And Pediatric Medicine, Inc. 407 E Washington St Greensboro NC 27401-2930 Ph: (336) 332-0824 | Triad Adult And Pediatric Medicine, Inc. 1002 S Eugene St Greensboro NC 27406-1308 Ph: (336) 355-9701 |
| NPI Number | 1609279504 |
|---|---|
| Provider Enumeration Date | 10/06/2014 |
| Last Update Date | 10/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609279504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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