| Passport Health Triad | |
|
3722 Vest Mill Rd Winston Salem NC 27103-2912 | |
| (336) 768-0717 | |
| (336) 768-0718 |
| Full Name | Passport Health Triad |
|---|---|
| Speciality | Clinic/center |
| Location | 3722 Vest Mill Rd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Amy Caroline Sapp (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3367680717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passport Health Triad 3722 Vest Mill Rd Winston Salem NC 27103-2912 Ph: (336) 768-0717 | Passport Health Triad 3722 Vest Mill Rd Winston Salem NC 27103-2912 Ph: (336) 768-0717 |
| NPI Number | 1902194426 |
|---|---|
| Provider Enumeration Date | 07/18/2011 |
| Last Update Date | 07/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902194426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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