GASTON FAMILY HEALTH SERVICES INC. NPI 1285270868

NPI Information

NPI: 1285270868
Provider Name: GASTON FAMILY HEALTH SERVICES, INC.

Doing Business As: KINTEGRA AT CENTRAL DAVIE ACADEMY

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
160 MARTIN LUTHER KING JUNIOR RD
MOCKSVILLE, NC
ZIP 27028
Phone: (336) 751-5712
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GASTON FAMILY HEALTH SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Mocksville, NC. GASTON FAMILY HEALTH SERVICES, INC. NPI is 1285270868. The provider is registered as an organization entity type.
The provider Is Doing Business As Kintegra At Central Davie Academy.

The provider's business location address is:

160 MARTIN LUTHER KING JUNIOR RD
MOCKSVILLE, NC
ZIP 27028
Phone: (336) 751-5712
Fax: (336) 751-5719

The provider's authorized official is Sharmila Alexander Anderson .
The authorized official title is Business Services Administrator and has the following contact phone number (704) 874-1907.

The CLIA number assigned to this NPI record is 34D2298575 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/19/2019 and was last updated on 12/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

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This page was last updated on: 5/5/2024

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