GASTON FAMILY HEALTH SERVICES INC. NPI 1578719886

NPI Information

NPI: 1578719886
Provider Name: GASTON FAMILY HEALTH SERVICES, INC.

Doing Business As: KINTEGRA/SHA AT ASHLEY WELLNESS CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
1647 NE ASHLEY SCHOOL CIRCLE
WINSTON-SALEM, NC
ZIP 27105
Phone: (336) 703-4205
Get Directions

GASTON FAMILY HEALTH SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Winston-salem, NC. GASTON FAMILY HEALTH SERVICES, INC. NPI is 1578719886. The provider is registered as an organization entity type.
The provider Is Doing Business As Kintegra/sha At Ashley Wellness Center.

The provider's business location address is:

1647 NE ASHLEY SCHOOL CIRCLE
WINSTON-SALEM, NC
ZIP 27105-444
Phone: (336) 703-4205
Fax: (336) 245-4592

The provider's authorized official is Sharmila Anderson .
The authorized official title is Business Services Administrator and has the following contact phone number (704) 874-1907.

The enumeration date for this NPI number is 8/18/2008 and was last updated on 10/1/2020.

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 State	Primary
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health		No
2	261QS1000X	Clinic/Center	Student Health	NORTH CAROLINA	No
3	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	6005802	MEDICAID	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: 4/28/2024

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