Organization
GOSHEN MEDICAL CENTER INCORPORATED
Active
Other names
Goshen Medical Center Wallace
Organization subpart
No
Provider details
NPI number
Authorized official
REBA W. FUTRELL (EXECUTIVE ASSISTANT/CREDENTIALING)
(910) 267-8252
Entity
Organization
Contact information
Practice address
110 EASTWOOD DRIVE, WALLACE, NC 28466-9236
(910) 285-2330
(910) 285-3060
Mailing address
PO BOX 187, FAISON, NC 28341-0187
(910) 267-0421
(910) 267-0441
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344011A
—
NC
Enumeration date
03/21/2007
Last updated
02/06/2012
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