Healthcare Provider Details

I. General information

NPI: 1356692065
Provider Name (Legal Business Name): ONSLOW AMBULATORY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2012
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 NEW RIVER DR
JACKSONVILLE NC
28540-5928
US

IV. Provider business mailing address

241 NEW RIVER DR
JACKSONVILLE NC
28540-5928
US

V. Phone/Fax

Practice location:
  • Phone: 910-577-2345
  • Fax:
Mailing address:
  • Phone: 910-577-2593
  • Fax: 910-577-4785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIBBY SCOTT
Title or Position: PRACTICE DIRECTOR
Credential:
Phone: 910-577-2533