MEDICARE: NEIGHBORHOOD IMPROVEMENT PROJECT INC

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	261QM1300X	Multi-Specialty Clinic/Center
2	261QI0500X	Infusion Therapy Clinic/Center

General Provider Information

NPI Number	:	1205688660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD IMPROVEMENT PROJECT INC

Provider Business Mailing Address
First Line	:	PO BOX 63169
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28263-3169
Country	:	US
Telephone Number	:	866-770-4104
Fax Number	:	706-790-4393

Provider Business Practice Location Address
First Line	:	1580 WALTON WAY
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30904-3763
Country	:	US
Telephone Number	:	706-790-4440
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	WESLEY WOOD
Credential	:
Telephone Number	:	706-790-4440

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	11/18/2024

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