# GENERAL MEDICAL CLINIC, PA

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

## Provider details

- **NPI number:** 1871522003
- **Authorized official:** TARSHIA DONNELL (REGIONAL DIRECTOR)
- **Authorized official phone:** (336) 301-4264

## Contact information

- **Practice address:** 2003 BOULEVARD ST STE C, GREENSBORO, NC 27407-4579
- **Practice address phone:** (336) 633-0407
- **Practice address fax:** (336) 633-0410
- **Mailing address:** PO BOX 788, GREENSBORO, NC 27402-0788
- **Mailing address phone:** (336) 301-4264
- **Mailing address fax:** (336) 633-0407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | 9700286 | NC | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/01/2006
- **Last updated:** 12/07/2023