MEDICARE: MONARCH

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1780091629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONARCH

Provider Business Mailing Address
First Line	:	350 PEE DEE AVE
Second Line	:	SUITE A
City	:	ALBEMARLE
State	:	NC
Zip	:	28001-4932
Country	:	US
Telephone Number	:	704-986-1522
Fax Number	:	704-982-5279

Provider Business Practice Location Address
First Line	:	106 OLD WEST END SCHOOL LANE
Second Line	:
City	:	WEST END
State	:	NC
Zip	:	27376-0000
Country	:	US
Telephone Number	:	704-986-1522
Fax Number	:	704-982-5279

Authorized Official
Title or Position	:	CFO
Name	:	MRS. CINDY JONES
Credential	:
Telephone Number	:	704-986-1522

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	07/11/2014

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Directions to “MONARCH ” Practice Location

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