| Granville Health Inc | |
|
100 Durham Street Stovall NC 27582 | |
| (919) 690-8880 | |
| (919) 690-8882 |
| Full Name | Granville Health Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Durham Street, Stovall, North Carolina |
| Authorized Official Name and Position | Georgeen Ertischek (ADM DIRECTOR) |
| Authorized Official Contact | 9196903280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granville Health Inc Po Box 986 Oxford NC 27565-0986 Ph: (919) 690-8880 | Granville Health Inc 100 Durham Street Stovall NC 27582 Ph: (919) 690-8880 |
| NPI Number | 1255565313 |
|---|---|
| Provider Enumeration Date | 05/05/2009 |
| Last Update Date | 10/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255565313 | NPI | - | NPPES |
| 5912213 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Rural Health Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Durham Street, Stovall, NC 27582 Phone: 252-536-5440 Fax: 252-536-5444 | |
Stovall Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Durham St., Stovall, NC 27582 Phone: 919-690-8880 Fax: 919-690-8882 |