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General NPI Number Information
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NPI Number | 1922820158
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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 | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 2000 CAROMONT PARKWAY SUITE 400
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City | BELMONT
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State | NC
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Zip | 28012
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Country | US
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Telephone | 704-865-7416
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Fax |
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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
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Country | US
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Telephone | 704-874-1936
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Fax |
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Authorized Official
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Title or Position | REV CYCLE MANAGER
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Name | SHARMILA ALEXANDER ANDERSON
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Credential |
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Telephone | 704-874-1907
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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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