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HEADACHE WELLNESS CENTER PC NPI 1811086242


NPI Information

NPI: 1811086242
Provider Name: HEADACHE WELLNESS CENTER PC

Doing Business As: EMG EEG CONSULTANTS

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 34D1068002

Address:
1414 YANCEYVILLE STREET
FIRST FLOOR
GREENSBORO, NC
ZIP 27405
Phone: (336) 574-8000
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HEADACHE WELLNESS CENTER PC is a specialist in Greensboro, NC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. HEADACHE WELLNESS CENTER PC NPI is 1811086242. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Emg Eeg Consultants.

The provider's business location address is:

1414 YANCEYVILLE STREET
FIRST FLOOR
GREENSBORO, NC
ZIP 27405-930
Phone: (336) 574-8000
Fax: (336) 574-8008

The provider's authorized official is Marshall Craig Freeman .
The authorized official title is Co Owner and has the following contact phone number (336) 574-8000.

The CLIA number assigned to this NPI record is 34D1068002 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/12/2006 and was last updated on 6/30/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist105374NORTH CAROLINAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
189015YMMEDICAIDNORTH CAROLINA
20101NOTHERNORTH CAROLINABCBSNC ID
3200200900OTHERNORTH CAROLINANC LICENSE
4C82563MEDICARE UPINNORTH CAROLINA
5I13471MEDICARE UPINNORTH CAROLINA
62339425MEDICARE PINNORTH 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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