Organization
STANLY MEDICAL SERVICES
Active
Other names
Mt Gilead Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
MARINDY BOST HARRIS (MANAGER REVENUE CYCLE)
(704) 983-7320
Entity
Organization
Contact information
Practice address
202 N MAIN ST, MOUNT GILEAD, NC 27306-9250
(910) 439-1573
(910) 439-1773
Mailing address
320 YADKIN ST, STE B, ALBEMARLE, NC 28001-3447
(704) 983-7320
(704) 983-6153
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0124R
BCBS
NC
01
—
2317250D
MEDICARE C
NC
01
—
348931
MEDICARE A
NC
01
—
348931A
MEDICAID A
NC
01
—
348931C
MEDICAID C
NC
Enumeration date
11/07/2005
Last updated
07/17/2013
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