| Pender Primary Care - Burgaw | |
|
209b Us Highway 117 N Burgaw NC 28425-5101 | |
| (910) 259-0600 | |
| (910) 259-3444 |
| Full Name | Pender Primary Care - Burgaw |
|---|---|
| Speciality | Internal Medicine |
| Location | 209b Us Highway 117 N, Burgaw, North Carolina |
| Authorized Official Name and Position | Dan E Goodwin (VP) |
| Authorized Official Contact | 9106677597 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pender Primary Care - Burgaw Po Box 602484 Charlotte NC 28260-2484 Ph: (910) 259-0600 | Pender Primary Care - Burgaw 209b Us Highway 117 N Burgaw NC 28425-5101 Ph: (910) 259-0600 |
| NPI Number | 1265733406 |
|---|---|
| Provider Enumeration Date | 11/04/2010 |
| Last Update Date | 01/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265733406 | NPI | - | NPPES |
| 5917056 | Medicaid | NC | |
| QPB708 | Medicaid | SC | |
| 1265733406 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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