MEDICARE: GOSHEN MEDICAL CENTER, INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1003227893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOSHEN MEDICAL CENTER, INCORPORATED

Provider Business Mailing Address
First Line	:	4114 DR M L KING JR BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2233
Country	:	US
Telephone Number	:	252-772-9995
Fax Number	:	910-267-8931

Provider Business Practice Location Address
First Line	:	4007 M L KING JR BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2243
Country	:	US
Telephone Number	:	252-772-9995
Fax Number	:	910-267-8931

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	MS. TEELA STRICKLAND
Credential	:
Telephone Number	:	910-267-2057

Provider Enumeration Date	:	05/14/2014
Last Update Date	:	03/05/2021

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