MEDICARE: PARKTON FAMILY MEDICAL CENTER

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
1	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02069	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407884596
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKTON FAMILY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	PO BOX 128
Second Line	:
City	:	PARKTON
State	:	NC
Zip	:	28371-0128
Country	:	US
Telephone Number	:	910-858-3913
Fax Number	:	910-858-3610

Provider Business Practice Location Address
First Line	:	15 W THIRD ST
Second Line	:
City	:	PARKTON
State	:	NC
Zip	:	28371
Country	:	US
Telephone Number	:	910-858-3913
Fax Number	:	910-858-3610

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MARSHA KINLEY
Credential	:
Telephone Number	:	910-858-3913

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	08/22/2020

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Directions to “PARKTON FAMILY MEDICAL CENTER ” Practice Location

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