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NPI Code Detail

MEDICARE: INTERVENTIONAL PAIN CENTER, PLLC

MEDICARE: INTERVENTIONAL PAIN CENTER, PLLC
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
1207LP2900XPain Medicine (Anesthesiology) Physician200100673NC

General Provider Information

NPI Number : 1912443821
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERVENTIONAL PAIN CENTER, PLLC
Provider Business Mailing Address
First Line : PO BOX 931038
Second Line :
City : ATLANTA
State : GA
Zip : 31193-1038
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2080 W ARLINGTON BLVD
Second Line : SUITE A
City : GREENVILLE
State : NC
Zip : 27834-3770
Country : US
Telephone Number : 252-689-6161
Fax Number : 252-689-6164
Authorized Official
Title or Position : RCM MANAGER
Name : SHANEKA TINCH
Credential :
Telephone Number : 469-458-9222
Provider Enumeration Date : 01/17/2017
Last Update Date : 12/08/2025

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Directions to “INTERVENTIONAL PAIN CENTER, PLLC ” Practice Location

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