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NPI Code Detail

MEDICARE: GRANVILLE HEALTH SYSTEM

MEDICARE: GRANVILLE HEALTH SYSTEM
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
1261QR1300XRural Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
302578OTHERNCBCBSNC

General Provider Information

NPI Number : 1265430854
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANVILLE HEALTH SYSTEM
Provider Business Mailing Address
First Line : PO BOX 986
Second Line :
City : OXFORD
State : NC
Zip : 27565-0986
Country : US
Telephone Number : 919-575-6103
Fax Number : 919-575-6817
Provider Business Practice Location Address
First Line : 1614 NC HIGHWAY 56
Second Line :
City : CREEDMOOR
State : NC
Zip : 27522-8297
Country : US
Telephone Number : 919-575-6103
Fax Number : 919-575-6817
Authorized Official
Title or Position : CFO
Name : JAMIE PURVIS
Credential :
Telephone Number : 919-690-3237
Provider Enumeration Date : 07/08/2005
Last Update Date : 10/11/2024

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Directions to “GRANVILLE HEALTH SYSTEM ” Practice Location

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