Organization Name: | MT. OLIVE FAMILY MEDICINE CENTER |
NPI Number: | 1639491038 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNY HEINE (SR. DIRECTOR OF OPERATIONS) |
Mailing Address: | 201 N Breazeale Ave Mount Olive |
State: | NC US |
Postal Code: | 283651603 |
Phone Number: | 9196584954 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2010 |
NPI Last Update Date: | 10/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332900000X |
License Number: | 9801525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Non-Pharmacy Dispensing Site |
Taxonomy Specialization: | |
Taxonomy Definition: | A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |