Healthcare Provider Details

I. General information

NPI: 1992082499
Provider Name (Legal Business Name): SCOTT FAMILY HEALTHCARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2011
Last Update Date: 11/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 PETE JONES DR
RICHLANDS NC
28574-8180
US

IV. Provider business mailing address

310 PETE JONES DR
RICHLANDS NC
28574-8180
US

V. Phone/Fax

Practice location:
  • Phone: 910-324-7268
  • Fax:
Mailing address:
  • Phone: 910-324-7268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number5004273
License Number StateNC

VIII. Authorized Official

Name: LELA M. HOPSON
Title or Position: OWNER
Credential: FNP
Phone: 910-324-7268