Healthcare Provider Details

I. General information

NPI: 1295552776
Provider Name (Legal Business Name): ANSON REGIONAL MEDICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 SALISBURY ST
WADESBORO NC
28170-2155
US

IV. Provider business mailing address

PO BOX 192
WADESBORO NC
28170-0192
US

V. Phone/Fax

Practice location:
  • Phone: 704-694-6700
  • Fax: 704-695-1227
Mailing address:
  • Phone: 704-694-6700
  • Fax: 704-695-1227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GWENDOLYN ELISE REED
Title or Position: CEO
Credential:
Phone: 704-694-6700