# AL-AQSA COMMUNITY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578303855
- **Authorized official:** AMAL KHDOUR (CLINIC COORDINATOR)
- **Authorized official phone:** (336) 350-1642

## Contact information

- **Practice address:** 1908 S MEBANE ST, BURLINGTON, NC 27215-6322
- **Practice address phone:** (336) 350-1642
- **Practice address fax:** (336) 395-8370
- **Mailing address:** 1908 S MEBANE ST, BURLINGTON, NC 27215-6322
- **Mailing address phone:** (336) 350-1642
- **Mailing address fax:** (336) 395-8370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/25/2024
- **Last updated:** 05/25/2024