Organization
GRANVILLE HEALTH SYSTEM
Active
Other names
South Granville Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE PURVIS (CFO)
(919) 690-3237
Entity
Organization
Contact information
Practice address
1614 NC HIGHWAY 56, CREEDMOOR, NC 27522-8297
(919) 575-6103
(919) 575-6817
Mailing address
PO BOX 986, OXFORD, NC 27565-0986
(919) 575-6103
(919) 575-6817
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02578
BCBSNC
NC
05
—
344645A
—
NC
05
—
344645C
—
NC
Enumeration date
07/08/2005
Last updated
10/11/2024
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