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General NPI Number Information
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NPI Number | 1710063144
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Entity Type | Organization
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Legal Business Name | GOLDEN GROVE EMERGENCY PHYSICIANS
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 401 NORTH MAIN STREET
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City | KENANSVILLE
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State | NC
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Zip | 28349
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Country | US
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Telephone | 910-296-0941
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 41628
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City | PHILADELPHIA
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State | PA
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Zip | 19101-1628
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Country | US
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Telephone | 800-444-7009
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Fax | 800-305-3233
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MR. JAMES L. MURPHY
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Credential |
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Telephone | 800-444-7009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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