Southside Medical Center Pa

LBN: Southside Medical Center Pa
Southside Medical Center Pa is an health care organization with primary practice located at 1925A Oleander Dr , Wilmington NC 28403-2334. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Southside Medical Center Pa can be contacted via phone (910) 251-7715, or through Pridgen, James Henry via phone (910) 251-7715.

Contact Information

Primary practice address
1925A Oleander Dr Wilmington NC 28403-2334
Phone: (910) 251-7715
Fax: (910) 763-7845
Website:
Map and Directions
Authorized official contact:
Name: Pridgen, James Henry Doctor of Medicine (MD)
Phone: (910) 251-7715

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 29495 North Carolina

Profile Details

NPI number 1003099409
LBN Legal business name Southside Medical Center Pa
DBA Doing business as
Authorized official Pridgen, James Henry Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 10th, 2007
Last updated May 17th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003099409 NPPES
North Carolina MEDICAID 89012R9

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