NPI | 1639633886 |
---|---|
Doing Business As | KINTEGRA/SHA AT HANES MAGNET |
Entity Type | Organization |
Authorized Contact | SHARMILA ALEXANDER ANDERSON Business Service Administrator 704-874-1907 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QS1000X Clinic/Center, Student Health |
Enumeration Date | 2019-01-22 |
Last Update Date | 2020-01-16 |