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NPI Code Detail

MEDICARE: VANCE FAMILY MEDICINE, PA

MEDICARE: VANCE FAMILY MEDICINE, 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
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

General Provider Information

NPI Number : 1619938479
Entity Type Code : Organization
Provider Name (Legal Business Name) : VANCE FAMILY MEDICINE, PA
Provider Business Mailing Address
First Line : 381 RUIN CREEK RD
Second Line :
City : HENDERSON
State : NC
Zip : 27536-2932
Country : US
Telephone Number : 252-430-0666
Fax Number : 252-430-7503
Provider Business Practice Location Address
First Line : 381 RUIN CREEK RD
Second Line :
City : HENDERSON
State : NC
Zip : 27536-2932
Country : US
Telephone Number : 252-430-0666
Fax Number : 252-430-7503
Authorized Official
Title or Position : OWNER
Name : KHANH T VU
Credential : MD
Telephone Number : 252-430-0666
Provider Enumeration Date : 03/31/2006
Last Update Date : 08/05/2010

Similar Medicare Providers

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Practice Location Address:
381 RUIN CREEK RD
HENDERSON, NC
27536-2932
Practice Phone: 252-430-0666
Practice Fax:
1679570717 — KHANH TUAN VU M.D.
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27536-2932
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1982625414 — DAVID J KLECZEK PA-C
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1245394709 — KRISTEN L WHITE PA-C
Practice Location Address:
381 RUIN CREEK RD
HENDERSON, NC
27536-2932
Practice Phone: 252-430-0666
Practice Fax:
1962695395 — MATTHEW STEPHEN HIGGINS MD
Practice Location Address:
381 RUIN CREEK RD
HENDERSON, NC
27536-2932
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Practice Fax: 252-430-7503
1538352968 — BENJAMIN SCOTT DIETER MD
Practice Location Address:
381 RUIN CREEK RD
HENDERSON, NC
27536-2932
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Practice Fax: 252-430-7503

Directions to “VANCE FAMILY MEDICINE, PA ” Practice Location

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