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NPI Code Detail

MEDICARE: PRIMARY HEALTH CHOICE, INC.

MEDICARE: PRIMARY HEALTH CHOICE, 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
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

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

General Provider Information

NPI Number : 1497785174
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMARY HEALTH CHOICE, INC.
Provider Business Mailing Address
First Line : PO BOX 159
Second Line :
City : SAINT PAULS
State : NC
Zip : 28384-0159
Country : US
Telephone Number : 910-865-3500
Fax Number :
Provider Business Practice Location Address
First Line : 227 E 4TH AVE
Second Line :
City : RED SPRINGS
State : NC
Zip : 28377-1603
Country : US
Telephone Number : 910-359-0021
Fax Number : 910-359-0024
Authorized Official
Title or Position : DIRECTOR
Name : MR. THAD J DAVIS
Credential :
Telephone Number : 910-865-3500
Provider Enumeration Date : 07/05/2006
Last Update Date : 02/02/2009

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Directions to “PRIMARY HEALTH CHOICE, INC. ” Practice Location

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