Organization
BEACHCARE URGENT MEDICAL CARE CENTER OF HAVELOCK
Active
Other names
Beachcare of Havelock
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM GRAHAM EVANS JR. PA-C (CLINICAL DIRECTOR/OWNER)
(252) 447-7474
Entity
Organization
Contact information
Practice address
1224 E MAIN ST, HAVELOCK, NC 28532-2405
(252) 447-7474
(252) 447-1050
Mailing address
1224 E MAIN ST, HAVELOCK, NC 28532-2405
(252) 447-7474
(252) 447-1050
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
39759
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0138B
BLUE CROSS BLUE SHIELD
NC
05
—
344612A
—
NC
05
—
344612C
—
NC
Enumeration date
09/27/2005
Last updated
11/04/2010
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