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Organization

MCKEITHAN HEALTH, PA

Active
Other names
Bolivia Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD M MCKEITHAN (OWNER)
(910) 253-7990
Entity
Organization

Contact information

Practice address
3875 BUSINESS 17 E, BOLIVIA, NC 28422-8666
(910) 253-7990
Mailing address
PO BOX 409, BOLIVIA, NC 28422-0409
(910) 253-7990

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
105024
NC

Other

Enumeration date
10/28/2008
Last updated
08/05/2009
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