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General NPI Number Information
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NPI Number | 1043338908
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Entity Type | Organization
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Legal Business Name | PRIMEHEALTH ASHEVILLE PA
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 1 VANDERBILT PARK DR STE 200
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City | ASHEVILLE
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State | NC
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Zip | 28803
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Country | US
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Telephone | 828-274-9920
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Fax |
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Provider Business Mailing Address
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Address Line | 1 VANDERBILT PARK DR STE 200
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City | ASHEVILLE
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State | NC
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Zip | 28803-1736
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Country | US
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Telephone | 828-274-9920
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LENA F LAUGHTER
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Credential |
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Telephone | 828-274-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 200200029
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License Number State | NC
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