Organization Name: | MASSEY HILL MEDICAL CENTER |
NPI Number: | 1003208992 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | COLLINS OSEKI (OWNER) |
Mailing Address: | 1074 Southern Ave Fayetteville |
State: | NC US |
Postal Code: | 283061766 |
Phone Number: | 9107235693 |
Fax Number: | |
NPI Enumeration Date: | 03/02/2015 |
NPI Last Update Date: | 03/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 2005-0522 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |