Granville Family Medicine Pa
LBN: Granville Family Medicine Pa
Granville Family Medicine Pa is an health care organization with primary practice located at 103 Professional Park Ste A , Oxford NC 27565-2581. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Granville Family Medicine Pa can be contacted via phone (919) 693-7108, or through Mahan, Dennis Michael via phone (919) 693-7108.
Contact Information
Primary practice address
103 Professional Park Ste A
Oxford NC 27565-2581
Phone: (919) 693-7108
Fax: (919) 693-9245
Website:
Authorized official contact:
Name: Mahan, Dennis Michael Doctor of Medicine (MD)
Phone: (919) 693-7108
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25053 | North Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 25053 | North Carolina |
Profile Details
| NPI number | 1093713695 |
|---|---|
| LBN Legal business name | Granville Family Medicine Pa |
| DBA Doing business as | |
| Authorized official | Mahan, Dennis Michael Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Sep 15th, 2014 - about 10 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 | 1093713695 | NPPES |
| North Carolina | MEDICAID | 343950A | |
| North Carolina | Other | 0171A | |
| North Carolina | MEDICAID | 343950C |
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