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PREMISE HEALTH OF NORTH CAROLINA MEDICAL P.C NPI 1063828366


NPI Information

NPI: 1063828366
Provider Name: PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C

Doing Business As: MY HEALTH CENTER AT LOWE'S MOORESVILLE

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 34D1050700

Address:
1000 LOWES BLVD
MOORESVILLE, NC
ZIP 28117
Phone: (704) 758-2000
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PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C is a clinic center in Mooresville, NC. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C NPI is 1063828366. The provider is registered as an organization entity type.
The provider Is Doing Business As My Health Center At Lowe's Mooresville.

The provider's business location address is:

1000 LOWES BLVD
MOORESVILLE, NC
ZIP 28117-520
Phone: (704) 758-2000
Fax: (704) 757-0510

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 34D1050700 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/8/2014 and was last updated on 8/24/2022.


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
1261Q00000XClinic/CenterYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.