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General NPI Number Information
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NPI Number | 1619938479
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Entity Type | Organization
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Legal Business Name | VANCE FAMILY MEDICINE, PA
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 381 RUIN CREEK RD
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City | HENDERSON
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State | NC
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Zip | 27536-2932
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Country | US
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Telephone | 252-430-0666
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Fax | 252-430-7503
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Provider Business Mailing Address
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Address Line | 381 RUIN CREEK RD
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City | HENDERSON
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State | NC
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Zip | 27536-2932
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Country | US
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Telephone | 252-430-0666
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Fax | 252-430-7503
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Authorized Official
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Title or Position | OWNER
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Name | KHANH T VU
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Credential | MD
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Telephone | 252-430-0666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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