Healthcare Provider Details

I. General information

NPI: 1366488280
Provider Name (Legal Business Name): METROPOLITAN COMMUNITY HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W MARTIN LUTHER KING JR DR
WASHINGTON NC
27889-4906
US

IV. Provider business mailing address

PO BOX 1886
WASHINGTON NC
27889-1886
US

V. Phone/Fax

Practice location:
  • Phone: 252-940-0602
  • Fax: 252-940-0605
Mailing address:
  • Phone: 252-940-0602
  • Fax: 252-940-0605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP0904X
TaxonomyFederal Public Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. LAURENCE J DOBY
Title or Position: OFFICE MANAGER
Credential:
Phone: 252-644-7003