| NPI | 1528429479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEYAN MAXINE GILES Nurse 252-824-8677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 63310) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2016-08-18 |