| NPI | 1023318961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ELLERBY Chief Executive Officer 336-272-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2012-08-09 |