Healthcare Provider Details

I. General information

NPI: 1538297106
Provider Name (Legal Business Name): NEW HANOVERCOMMUNITY HEATH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 N 4TH ST
WILMINGTON NC
28401-3450
US

IV. Provider business mailing address

925 N 4TH ST
WILMINGTON NC
28401-3450
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-0270
  • Fax: 910-251-1540
Mailing address:
  • Phone: 910-343-0270
  • Fax: 910-251-1540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9049
License Number StateNC

VIII. Authorized Official

Name: MR. STEVEN A IPOCK
Title or Position: DIRECTOR OF PHARMACY
Credential: RPH
Phone: 910-343-0270