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EASTRIDGE FAMILY MEDICINE NPI 1477589158


NPI Information

NPI: 1477589158
Provider Name: EASTRIDGE FAMILY MEDICINE

Doing Business As: EASTRIDGE FAMILY MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 34D0243039

Address:
1896 REMOUNT RD
GASTONIA, NC
ZIP 28054
Phone: (704) 512-3930
Get Directions

EASTRIDGE FAMILY MEDICINE is a family medicine in Gastonia, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EASTRIDGE FAMILY MEDICINE NPI is 1477589158. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Eastridge Family Medicine.

The provider's business location address is:

1896 REMOUNT RD
GASTONIA, NC
ZIP 28054-414
Phone: (704) 512-3930

The provider's authorized official is Scott Rissmiller .
The authorized official title is Enterprise Evp and has the following contact phone number (704) 355-8675.

The CLIA number assigned to this NPI record is 34D0243039 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 3/9/2023.


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
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

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

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