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NPI Code Detail

MEDICARE: LAKE NORMAN COMMUNITY HEALTH CLINIC

MEDICARE: LAKE NORMAN COMMUNITY HEALTH CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1376033845
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE NORMAN COMMUNITY HEALTH CLINIC
Provider Business Mailing Address
First Line : PO BOX 2398
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28070-2398
Country : US
Telephone Number : 704-316-6611
Fax Number : 704-316-6612
Provider Business Practice Location Address
First Line : 14230 HUNTERS RD
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-7335
Country : US
Telephone Number : 704-316-6611
Fax Number : 704-316-6612
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : APRIL COOK
Credential :
Telephone Number : 704-316-6611
Provider Enumeration Date : 05/10/2018
Last Update Date : 05/10/2018

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Directions to “LAKE NORMAN COMMUNITY HEALTH CLINIC ” Practice Location

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