Organization
GENERAL MEDICAL CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARSHIA DONNELL (REGIONAL DIRECTOR)
(336) 301-4264
Entity
Organization
Contact information
Practice address
2003 BOULEVARD ST STE C, GREENSBORO, NC 27407-4579
(336) 633-0407
(336) 633-0410
Mailing address
PO BOX 788, GREENSBORO, NC 27402-0788
(336) 301-4264
(336) 633-0407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
9700286
NC
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902980
—
NC
Enumeration date
07/01/2006
Last updated
12/07/2023
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