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	:	1548711963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOSHEN MEDICAL CENTER INCORPORATED

Provider Business Mailing Address
First Line	:	444 SW CENTER ST
Second Line	:
City	:	FAISON
State	:	NC
Zip	:	28341-8820
Country	:	US
Telephone Number	:	910-267-0421
Fax Number	:	855-996-9090

Provider Business Practice Location Address
First Line	:	4654 LONG BEACH RD SE
Second Line	:
City	:	SOUTHPORT
State	:	NC
Zip	:	28461-8799
Country	:	US
Telephone Number	:	910-457-0070
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. GREG BOUNDS
Credential	:
Telephone Number	:	910-267-1942

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	05/29/2019

Similar Medicare Providers

1043207749 — DR. JOHN D IRVIN MD
Practice Location Address:

4654 LONG BEACH RD SE
SOUTHPORT, NC
28461-8799

Practice Phone: 910-457-9564
Practice Fax: 910-457-6744

1356433171 — JOHN SARDELLA PA-C
Practice Location Address:

4654 LONG BEACH RD SE
SOUTHPORT, NC
28461-8799

Practice Phone: 910-457-9564
Practice Fax:

1912127994 — JAMES R FORSTNER
Practice Location Address:

4654 LONG BEACH RD SE
SOUTHPORT, NC
28461-8799

Practice Phone: 910-457-9564
Practice Fax: 910-457-6744

1922414754 — CAROLINA COMPREHENSIVE HEALTH
Practice Location Address:

4654 LONG BEACH RD SE
SOUTHPORT, NC
28461-8799

Practice Phone: 910-457-9564
Practice Fax: 910-457-6744

1669328258 — RICCOBENE & ASSOCIATES I, DDS, P.A.
Practice Location Address:

5021 SOUTHPORT CROSSINGS WAY STE 310
SOUTHPORT, NC
28461

Practice Phone: 910-375-9579
Practice Fax:

1215936356 — DOMENIC A PALAGRUTO D.O.
Practice Location Address:

3599 GEORGE II HWY
SOUTHPORT, NC
28461-7793

Practice Phone: 910-845-3244
Practice Fax: 910-845-3276

Directions to “GOSHEN MEDICAL CENTER INCORPORATED ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.