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Organization
PORT HEALTH SERVICES
Active
Organization
PORT HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT BEAVERS (CREDENTIALING MANAGER)
(919) 210-7661
Entity
Organization
Contact information
Practice address
132 FOY DR, ROCKY MOUNT, NC 27804-2417
(252) 413-1916
(252) 210-3120
Mailing address
4300 SAPPHIRE CT STE 110, GREENVILLE, NC 27834-9079
(252) 830-7540
(252) 413-0932
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/14/2018
Last updated
05/15/2023
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