| Stanly Co Hlth Dept - Healthcheck-epsdt- Fp | |
|
1000 N 1st St Suite 3 Albemarle NC 28001-2819 | |
| (704) 982-9171 | |
| (704) 982-8354 |
| Full Name | Stanly Co Hlth Dept - Healthcheck-epsdt- Fp |
|---|---|
| Speciality | Clinic/Center |
| Location | 1000 N 1st St, Albemarle, North Carolina |
| Authorized Official Name and Position | Glenn David Jenkins (HEALTH AND HUMAN SERVICES) |
| Authorized Official Contact | 7049829171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanly Co Hlth Dept - Healthcheck-epsdt- Fp 1000 N 1st St Suite 3 Albemarle NC 28001-2819 Ph: (704) 982-9171 | Stanly Co Hlth Dept - Healthcheck-epsdt- Fp 1000 N 1st St Suite 3 Albemarle NC 28001-2819 Ph: (704) 982-9171 |
| NPI Number | 1124167796 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 10/24/2018 |
| Medicare PECOS PAC ID | 2466594619 |
|---|---|
| Medicare Enrollment ID | O20190916000665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124167796 | NPI | - | NPPES |
| 3404384 | Medicaid | NC |
| Provider Name | Patricia M Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366540635 PECOS PAC ID: 7517282452 Enrollment ID: I20150217000811 |
| Provider Name | Alaina Gobush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235702564 PECOS PAC ID: 7113382862 Enrollment ID: I20230502001313 |
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