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General NPI Number Information
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NPI Number | 1164347332
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Entity Type | Organization
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Legal Business Name | GASTON FAMILY HEALTH SERVICES, INC
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 300 ELK SPUR ST
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City | ELKIN
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State | NC
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Zip | 28621-3308
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Country | US
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Telephone | 336-835-3175
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Fax | 336-835-1427
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Provider Business Mailing Address
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Address Line | 200 E 2ND AVE
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City | GASTONIA
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State | NC
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Zip | 28052-4358
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Country | US
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Telephone | 704-874-1900
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | MOLLY BROWN QUACKENBUSH
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Credential |
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Telephone | 704-874-1904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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