# GRANVILLE HEALTH INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stovall Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255565313
- **Authorized official:** GEORGEEN ERTISCHEK (ADM DIRECTOR)
- **Authorized official phone:** (919) 690-3280

## Contact information

- **Practice address:** 100 DURHAM STREET, STOVALL, NC 27582
- **Practice address phone:** (919) 690-8880
- **Practice address fax:** (919) 690-8882
- **Mailing address:** PO BOX 986, OXFORD, NC 27565-0986
- **Mailing address phone:** (919) 690-8880
- **Mailing address fax:** (919) 690-8882

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/05/2009
- **Last updated:** 10/30/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5912213 | — | NC |