Old Town Family Medicine, P A
LBN: Old Town Family Medicine, P A
Old Town Family Medicine, P A is an health care organization with primary practice located at 3690 Reynolda Rd , Winston Salem NC 27106-2230. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty.
Old Town Family Medicine, P A can be contacted via phone (336) 922-1363, or through Herber, Richard Ray via phone (336) 922-1363.
Contact Information
Primary practice address
3690 Reynolda Rd
Winston Salem NC 27106-2230
Phone: (336) 922-1363
Fax:
Website:
Authorized official contact:
Name: Herber, Richard Ray Doctor of Medicine (MD)
Phone: (336) 922-1363
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | 39614 | North Carolina |
Profile Details
| NPI number | 1447370101 |
|---|---|
| LBN Legal business name | Old Town Family Medicine, P A |
| DBA Doing business as | |
| Authorized official | Herber, Richard Ray Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 29th, 2007 |
| Last updated | Jan 26th, 2012 - about 12 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 | 1447370101 | NPPES |
| North Carolina | MEDICAID | 8941873 |
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