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NPI Code Detail

MEDICARE: VILLAGE FAMILY CARE CENTER PA

MEDICARE: VILLAGE FAMILY CARE CENTER PA
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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1018EYOTHERNCBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3DE6262OTHERNCRAILROAD PTAN

General Provider Information

NPI Number : 1346359908
Entity Type Code : Organization
Provider Name (Legal Business Name) : VILLAGE FAMILY CARE CENTER PA
Provider Business Mailing Address
First Line : PO BOX 1689
Second Line :
City : ETOWAH
State : NC
Zip : 28729-1689
Country : US
Telephone Number : 828-891-5524
Fax Number :
Provider Business Practice Location Address
First Line : 1248 FORT BRAGG RD
Second Line : SUITE 200
City : FAYETTEVILLE
State : NC
Zip : 28305-4981
Country : US
Telephone Number : 910-486-6818
Fax Number :
Authorized Official
Title or Position : CREDENTIALING
Name : STEPHANIE FEILMEIER
Credential :
Telephone Number : 828-233-1354
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/05/2012

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1679597025 — DR. GEORGE CONSTANTINE PANTELAKOS MD
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1255417838 — MRS. BRENDA GALVIN BOOTH NP
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1114006533 — DR. ROBERT WILLIAM TWADDELL D.C.
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Practice Location Address:
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1326497579 — MS. OLIVIA JOY AYRE
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Directions to “VILLAGE FAMILY CARE CENTER PA ” Practice Location

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