Organization
ASSOCIATION OF GOODFELLOWS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALPHONSO CHERRY (OWNER/ADMINISTRATOR)
(252) 377-7081
Entity
Organization
Contact information
Practice address
310 EBONY RD, LITTLETON, NC 28590
(252) 586-4867
(252) 586-4867
Mailing address
PO BOX 506, AULANDER, NC 27805
(252) 377-7081
(252) 565-5008
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
FCL093010
NC
Other
Enumeration date
12/28/2009
Last updated
12/28/2009
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