Black River Family Practice
LBN: Black River Health Services Inc
Black River Family Practice is an health care organization with primary practice located at 301 S Campbell St , Burgaw NC 28425-5011. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty.
Black River Health Services Inc can be contacted via phone (910) 259-5721, or through Amann, Lee Ann via phone (910) 259-6973.
Contact Information
Primary practice address
301 S Campbell St
Burgaw NC 28425-5011
Phone: (910) 259-5721
Fax: (910) 259-8002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X | ||
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X |
Profile Details
| NPI number | 1093703886 |
|---|---|
| LBN Legal business name | Black River Health Services Inc |
| DBA Doing business as | Black River Family Practice |
| Authorized official | Amann, Lee Ann |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 6th, 2005 |
| Last updated | Dec 12th, 2019 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093703886 | NPPES |
| Other | 0104X | BCBS | |
| MEDICAID | 343905AC | BCBS |
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