| NPI | 1033860564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMILLE JACKSON Medical Revenue Cycle Supervision 919-896-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2022-01-17 |