Organization
PROFESSONAL FAMILY HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHALEACCA RESHAUN VAUGHAN (PRESIDENT)
(252) 398-3350
Entity
Organization
Contact information
Practice address
130 SPRING BRANCH RD, MURFREESBORO, NC 27855-9577
(252) 398-3350
Mailing address
PO BOX 111, MURFREESBORO, NC 27855-0111
(252) 398-3350
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
HC2949
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601250
—
NC
Enumeration date
03/30/2007
Last updated
08/22/2020
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