Goshen Medical Center Incorporated
Organization Active NPI Community/Retail Pharmacy · Faison, NC
NPI 1063043370 · NPPES record last updated Oct 28, 2022
Key facts
- NPI
- 1063043370
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- GOSHEN MEDICAL CENTER INCORPORATED
- Practice address
- 444 SW Center St
Faison, NC 28341-8820 - Phone
- (910) 718-5200
- NPI assigned
- Jan 27, 2020
- Organization subpart
- No
Authorized official
- Name
- Gregory M Bounds
- Title
- Ceo
- Phone
- (910) 267-1237
Other NPIs on the same Medicare enrollment 11
Corporate family (same tax ID) 41
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200314000263 | NC | Part B Supplier - Pharmacy | 3173434479 |
Receives reassigned benefits from 1 practitioner 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Whiteville, NC; Star, NC; Sanford, NC; Rockingham, NC; New Bern, NC; Morehead City, NC; Goldsboro, NC; Faison, NC… |
National Provider Directory
- Tax ID family
- Goshen Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | |||
| Pharmacy | 333600000X | |||
| Clinic Pharmacy | 3336C0002X | |||
| Community/Retail Pharmacy | 3336C0003X | Yes | ||
| Mail Order Pharmacy | 3336M0002X |
Addresses
Primary practice location
444 SW Center St
Faison, NC 28341-8820
Mailing address
444 SW Center St
Faison, NC 28341-8820
Phone (910) 718-5200
Other names
- GMC FAISON PHARMACY
Other providers in Faison, NC
- Lauren Eades
- Bryan Francis
- Michael T Futrell
- Dara L. Garces
- John Louis Gentri
- Goshen Medical Center Incorporated
- Goshen Medical Center Incorporated
- Goshen Medical Center Incorporated
- Goshen Medical Center Incorporated
- Karen Lynn Halter
All providers in Faison, NC · Community/Retail Pharmacy in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.