Healthcare Provider Details

I. General information

NPI: 1467887224
Provider Name (Legal Business Name): NEW HANOVER COMMUNITY HEALTH CENTER DBA MEDNORTH HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 09/11/2013
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 Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number261QF0400X
License Number StateNC

VIII. Authorized Official

Name: MS. ANGANETTE S YOUNG
Title or Position: CEO
Credential: MSW
Phone: 910-343-0270