Organization
BLACK RIVER HEALTH SERVICES INC
Active
Organization
BLACK RIVER HEALTH SERVICES INC
Active
Other names
Maple Hill Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
LEEANN AMANN (ADMINISTRATOR)
(910) 259-6973
Entity
Organization
Contact information
Practice address
4811 NC HIGHWAY 50, MAPLE HILL, NC 28454-8153
(910) 259-6444
(910) 259-6659
Mailing address
301 S CAMPBELL ST, BURGAW, NC 28425-5011
(910) 259-6973
(910) 259-6975
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176J
BCBS
—
05
—
344622AC
—
NC
Enumeration date
10/06/2005
Last updated
01/21/2020
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