| NPI | 1790980498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA I. HENDRIX CEO 336-274-9862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NC 8301074) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2020-08-22 |