Organization
ADVANCE COMMUNITY HEALTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENELLA M WASHINGTON (CEO)
(919) 250-2923
Entity
Organization
Contact information
Practice address
130 N JUDD PKWY NE, FUQUAY VARINA, NC 27526-2367
(919) 833-3111
(919) 834-3118
Mailing address
1001 ROCK QUARRY RD, RALEIGH, NC 27610-3825
(919) 833-3111
(919) 834-3118
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344584C
—
NC
Enumeration date
03/18/2009
Last updated
04/21/2020
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