SNOWY MOUNTAIN MANAGEMENT PLLC NPI 1306050588

NPI Information

NPI: 1306050588
Provider Name: SNOWY MOUNTAIN MANAGEMENT PLLC

Doing Business As: SHIPYARD MEDICAL CENTER

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2632 CAROLINA BEACH RD
WILMINGTON, NC
ZIP 28412
Phone: (910) 409-0922
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SNOWY MOUNTAIN MANAGEMENT PLLC is a primary care clinic center in Wilmington, NC. SNOWY MOUNTAIN MANAGEMENT PLLC NPI is 1306050588. The provider is registered as an organization entity type.
The provider Is Doing Business As Shipyard Medical Center.

The provider's business location address is:

2632 CAROLINA BEACH RD
WILMINGTON, NC
ZIP 28412-806
Phone: (910) 409-0922

The provider's authorized official is Chris Donovin .
The authorized official title is Owner and has the following contact phone number (919) 931-0490.

The CLIA number assigned to this NPI record is 34D1067221 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2007 and was last updated on 9/25/2007.

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	261QP2300X	Clinic/Center	Primary Care	NC102817	NORTH CAROLINA	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	5906809	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

NPI Synchronization or Removal

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