Organization
BLACK RIVER HEALTH SERVICES, INC.
Active
Other names
Black River Family Practice at Rocky Point
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS SCOTT MARTIN (EXECUTIVE DIRECTOR)
(910) 259-6973
Entity
Organization
Contact information
Practice address
7910 US HIGHWAY 117 S, SUITE 120, ROCKY POINT, NC 28457-7409
(910) 675-0120
(910) 675-2308
Mailing address
301 S CAMPBELL ST, BURGAW, NC 28425-5011
(910) 259-6973
(910) 259-6975
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020A0
BCBS NC
NC
05
—
5908417
—
NC
Enumeration date
09/05/2007
Last updated
07/21/2022
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