Organization
GASTON FAMILY HEALTH SERVICES INC
Active
Parent organization
GASTON FAMILY HEALTH SERVICES INC
Other names
Kintegra Family Medicine - Highland
Organization subpart
Yes
Provider details
NPI number
Legal business name
GASTON FAMILY HEALTH SERVICES INC
Authorized official
SHARMILA ALEXANDER ANDERSON (BUSINESS SERVICE ADMIN)
(704) 874-1907
Entity
Organization
Contact information
Practice address
609 N HIGHLAND ST, GASTONIA, NC 28052-2179
(704) 772-4700
(704) 833-1553
Mailing address
200 E 2ND AVE, GASTONIA, NC 28052-4358
(704) 874-1904
(704) 864-7608
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3420154
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/23/2009
Last updated
02/01/2021
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