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General NPI Number Information
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NPI Number | 1831306992
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Entity Type | Organization
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Legal Business Name | HOPSCOTCH PRIMARY CARE GROUP, PA
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 113 E GROVER ST
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City | SHELBY
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State | NC
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Zip | 28150-3803
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Country | US
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Telephone | 704-487-5228
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Fax | 704-482-4284
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Provider Business Mailing Address
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Address Line | 113 E GROVER ST
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City | SHELBY
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State | NC
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Zip | 28150-3803
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Country | US
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Telephone | 704-487-5228
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Fax | 704-482-4284
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. THIRATH CHAU
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Credential | MD
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Telephone | 337-860-4721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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