Organization Name: | CHERRYVILLE PRIMARY CARE |
NPI Number: | 1174881940 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS WHITE (DOCTOR) |
Mailing Address: | 112 Oak St Cherryville |
State: | NC US |
Postal Code: | 280213423 |
Phone Number: | 9804872200 |
Fax Number: | |
NPI Enumeration Date: | 04/30/2012 |
NPI Last Update Date: | 04/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 207771 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |