Organization
GASTON FAMILY HEALTH SERVICES, INC.
Active
Organization
GASTON FAMILY HEALTH SERVICES, INC.
Active
Parent organization
GASTON FAMILY HEALTH SERVICES, INC
Other names
Kintegra/SHA at Mineral Springs
Organization subpart
Yes
Provider details
NPI number
Legal business name
GASTON FAMILY HEALTH SERVICES, INC
Authorized official
SHARMILA ANDERSON (BUSINESS SERVICES ADMINISTRATOR)
(704) 874-1907
Entity
Organization
Contact information
Practice address
4555 OGBURN AVE, WINSTON SALEM, NC 27105-2726
(336) 703-4273
(336) 661-4954
Mailing address
200 E 2ND AVE, GASTONIA, NC 28052-4358
(704) 874-1904
(704) 874-0707
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QS1000X
Student Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8701701
—
NC
05
—
89011N0
—
NC
Enumeration date
03/12/2007
Last updated
01/15/2020
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