Organization
LOUISBURG PPM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY D MCLEMORE (SR. VP OPERATIONS FINANCE)
(239) 598-3131
Entity
Organization
Contact information
Practice address
1501 N BICKETT BLVD, SUITE G, LOUISBURG, NC 27549-2178
(919) 496-5774
Mailing address
PO BOX 239, LOUISBURG, NC 27549-0239
(919) 496-5774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/14/2009
Last updated
01/16/2009
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