| NPI | 1760517155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARVETTE C JENKINS Medical Director 336-641-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| 261QP0905X Clinic/Center Public Health, State or Local | |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| 291U00000X Clinical Medical Laboratory | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |