Organization
HEALTH PLUS OF NC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY R ELLIOTT LPN (OFFICE MANAGER)
(910) 974-7555
Entity
Organization
Contact information
Practice address
210 EAST MAIN ST., CANDOR, NC 27229-8088
(910) 974-7555
(910) 974-4555
Mailing address
210 EAST MAIN ST., CANDOR, NC 27229-8088
(910) 974-7555
(910) 974-4555
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
9701632
NC
208D00000X
General Practice Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
101376
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2344648
MEDICARE
NC
05
—
89011WU
—
NC
01
—
O11WU
BCBS
NC
Enumeration date
08/10/2006
Last updated
01/13/2010
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