GASTON FAMILY HEALTH SERVICES INC NPI 1316577406

NPI Information

NPI: 1316577406
Provider Name: GASTON FAMILY HEALTH SERVICES, INC

Doing Business As: KINTEGRA FAMILY DENTISTRY-STATESVILLE

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
518 BROOKDALE DR
STATESVILLE, NC
ZIP 28677
Phone: (704) 838-1108
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GASTON FAMILY HEALTH SERVICES, INC is a federally qualified health center (fqhc) clinic center in Statesville, NC. GASTON FAMILY HEALTH SERVICES, INC NPI is 1316577406. The provider is registered as an organization entity type.
The provider Is Doing Business As Kintegra Family Dentistry-statesville.

The provider's business location address is:

518 BROOKDALE DR
STATESVILLE, NC
ZIP 28677-108
Phone: (704) 838-1108
Fax: (704) 671-1404

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

The CLIA number assigned to this NPI record is 34D2298579 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/17/2020 and was last updated on 2/18/2020.

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 Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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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