Organization
STATESVILLE MEDICAL MANAGEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIKA SMITH (MANAGER)
(704) 896-3313
Entity
Organization
Contact information
Practice address
1503 E BROAD ST, STATESVILLE, NC 28625-4301
(704) 896-3313
Mailing address
16511-A NORTHCROSS DRIVE, HUNTERSVILLE, NC 28078-5021
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34D2076118
CLIA CERTIFICATE
—
Enumeration date
10/14/2014
Last updated
10/15/2014
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