Organization
BOICE-WILLIS CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN S ADAMS (CREDENTIALING SPECIALIST)
(252) 937-0200
Entity
Organization
Contact information
Practice address
901 N WINSTEAD AVE, ROCKY MOUNT, NC 27804-8467
(252) 937-0200
(252) 937-2903
Mailing address
PO BOX 7200, ROCKY MOUNT, NC 27804-0200
(252) 937-0200
(252) 451-0056
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
38821
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8900465
—
NC
Enumeration date
08/18/2008
Last updated
02/15/2024
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