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Organization

EXCELLENT SPIRIT ENTERPRISE, INC.

Active
Other names
Medical Clinic of Sharpsburg
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN ROBERT PICKETT SR. D.O. (FOUNDER/CEO)
(252) 446-4455
Entity
Organization

Contact information

Practice address
9201 COUNTY LINE ROAD, SHARPSBURG, NC 27878-9998
(252) 446-4455
(704) 625-0372
Mailing address
PO BOX 98, SHARPSBURG, NC 27878-0098
(252) 446-4455
(704) 625-0372

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
200000114
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
344644A
NC
05
344644C
NC
Enumeration date
09/14/2009
Last updated
03/29/2011
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