| NPI | 1093703886 |
|---|---|
| Doing Business As | BLACK RIVER FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | LEE ANN AMANN Administrator 910-259-6973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2019-12-12 |