GOSHEN MEDICAL CENTER INCORPORATED NPI 1164695375

NPI Information

NPI: 1164695375
Provider Name: GOSHEN MEDICAL CENTER INCORPORATED

Other Name: GOSHEN MEDICAL CENTER BOLTON

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
213 9TH ST
BOLTON, NC
ZIP 28423
Phone: (910) 655-8300
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GOSHEN MEDICAL CENTER INCORPORATED is a federally qualified health center (fqhc) clinic center in Bolton, NC. GOSHEN MEDICAL CENTER INCORPORATED NPI is 1164695375. The provider is registered as an organization entity type.
The provider Other Name Is Goshen Medical Center Bolton.

The provider's business location address is:

213 9TH ST
BOLTON, NC
ZIP 28423-410
Phone: (910) 655-8300

The provider's authorized official is Rebecca M Brown .
The authorized official title is Credentialing and has the following contact phone number (910) 267-8252.

The CLIA number assigned to this NPI record is 34D1051327 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/9/2008 and was last updated on 2/18/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	341940	MEDICARE OSCAR/CERTIFICATION	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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