| Lucas Exceptional Healthcare And Consultation Pllc | |
|
2211 W Meadowview Rd Ste 107 Greensboro NC 27407-3408 | |
| (336) 543-0480 | |
| (336) 313-2417 |
| Full Name | Lucas Exceptional Healthcare And Consultation Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2211 W Meadowview Rd Ste 107, Greensboro, North Carolina |
| Authorized Official Name and Position | Latoya Lucas (CEO) |
| Authorized Official Contact | 3365430480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lucas Exceptional Healthcare And Consultation Pllc 2211 W Meadowview Rd Ste 107 Greensboro NC 27407-3408 Ph: (336) 543-0480 | Lucas Exceptional Healthcare And Consultation Pllc 2211 W Meadowview Rd Ste 107 Greensboro NC 27407-3408 Ph: (336) 543-0480 |
| NPI Number | 1447927595 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 10/05/2023 |
| Medicare PECOS PAC ID | 8325427875 |
|---|---|
| Medicare Enrollment ID | O20220614001625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447927595 | NPI | - | NPPES |
| 1447927595 | Medicaid | NC | |
| 5004800 | Other | NC | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Secondary |
| Provider Name | Latoya Davis Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750696274 PECOS PAC ID: 8628292885 Enrollment ID: I20240821002445 |
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