TRIAD ADULT AND PEDIATRIC MEDICINE INC. NPI 1598762940

NPI Information

NPI: 1598762940
Provider Name: TRIAD ADULT AND PEDIATRIC MEDICINE, INC.

Doing Business As: GUILFORD CHILD HEALTH-WENDOVER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
1046 E WENDOVER AVE
GREENSBORO, NC
ZIP 27405
Phone: (336) 272-1050
Get Directions

TRIAD ADULT AND PEDIATRIC MEDICINE, INC. is a federally qualified health center (fqhc) clinic center in Greensboro, NC. TRIAD ADULT AND PEDIATRIC MEDICINE, INC. NPI is 1598762940. The provider is registered as an organization entity type.
The provider Is Doing Business As Guilford Child Health-wendover.

The provider's business location address is:

1046 E WENDOVER AVE
GREENSBORO, NC
ZIP 27405-712
Phone: (336) 272-1050
Fax: (336) 272-0155

The provider's authorized official is Brian K Ellerby .
The authorized official title is Chief Executive Officer and has the following contact phone number (336) 272-1050.

The CLIA number assigned to this NPI record is 34D0926152 - other - fqhc with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2005 and was last updated on 8/29/2011.

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

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	2348638A	OTHER	NORTH CAROLINA	MEDICARE
2	890244U	MEDICAID	NORTH CAROLINA
3	0244U	OTHER	NORTH CAROLINA	BCBS OF NC
4	34D0926152	OTHER	NORTH CAROLINA	CLIA

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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