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Organization

JACKSONVILLE FAMILY MEDICAL CENTER, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VERLETA R THOMAS (MANAGER)
(910) 938-3200
Entity
Organization

Contact information

Practice address
2587 HENDERSON DR, JACKSONVILLE, NC 28546-5253
(910) 938-3200
(910) 938-3043
Mailing address
2587 HENDERSON DR, JACKSONVILLE, NC 28546-5253
(910) 938-3200
(910) 938-3043

Taxonomy

Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
Primary
36058
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89011JH
NC
01
D75607
UPIN
NC
Enumeration date
08/30/2007
Last updated
08/30/2007
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