Organization
WARREN COMMUNITY HEALTH CLINIC INC.
Active
Organization
WARREN COMMUNITY HEALTH CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY JONES SOMERVILLE ETC (EXECUTIVE DIRECTOR)
(252) 257-1904
Entity
Organization
Contact information
Practice address
546 W RIDGEWAY ST, WARRENTON, NC 27589-1716
(252) 257-1904
(252) 257-1142
Mailing address
546 W RIDGEWAY ST, WARRENTON, NC 27589-1716
(252) 257-1904
(252) 257-1142
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D901
PROVIDER TRANSACTION ACCESS NUMBER(PTAN)
NC
Enumeration date
06/10/2011
Last updated
11/03/2014
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