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Organization
IREDELL PHYSICIAN NETWORK LLC
Active
Organization
IREDELL PHYSICIAN NETWORK LLC
Active
Parent organization
IREDELL PHYSICIAN NETWORK LLC
Other names
Union Grove Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
IREDELL PHYSICIAN NETWORK LLC
Authorized official
MS. ANNA PURCELL (DIRECTOR)
(704) 878-4569
Entity
Organization
Contact information
Practice address
955 WEST MEMORIAL HIGHWAY, HARMONY, NC 28634-9352
(704) 878-4569
Mailing address
PO BOX 25867, WINSTON SALEM, NC 27114-5867
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5911498
—
NC
Enumeration date
02/12/2009
Last updated
05/17/2010
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