Organization
GRANVILLE HEALTH INC
Active
Other names
Stovall Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGEEN ERTISCHEK (ADM DIRECTOR)
(919) 690-3280
Entity
Organization
Contact information
Practice address
100 DURHAM STREET, STOVALL, NC 27582
(919) 690-8880
(919) 690-8882
Mailing address
PO BOX 986, OXFORD, NC 27565-0986
(919) 690-8880
(919) 690-8882
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5912213
—
NC
Enumeration date
05/05/2009
Last updated
10/30/2013
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