| Lagrange Pediatrics PA | |
|
114 E Railroad Street Lagrange NC 28551 | |
| (252) 566-5999 | |
| (252) 566-4430 |
| Full Name | Lagrange Pediatrics PA |
|---|---|
| Speciality | Clinic/Center |
| Location | 114 E Railroad Street, Lagrange, North Carolina |
| Authorized Official Name and Position | Michael Allen Riddick (PRACTICE MANAGER) |
| Authorized Official Contact | 9197344736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lagrange Pediatrics PA 114 E Railroad Street Lagrange NC 28551 Ph: (252) 566-5999 | Lagrange Pediatrics PA 114 E Railroad Street Lagrange NC 28551 Ph: (252) 566-5999 |
| NPI Number | 1497523625 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 02/10/2026 |
| Certification Date | 02/10/2026 |
| Medicare PECOS PAC ID | 5799687174 |
|---|---|
| Medicare Enrollment ID | O20250609003176 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497523625 | NPI | - | NPPES |
| 8901644 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| 208000000X | Pediatrics | () | Secondary |
Ant Mary's Family Care #1 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 West James Street, Ant Mary's Family Care Home #1, Lagrange, NC 28551 Phone: 919-344-9903 |