Hometown Direct Primary Care PLLC

Organization Active NPI Primary Care Clinic/Center · Coats, NC

NPI 1164042412 · NPPES record last updated Apr 10, 2025

Key facts

NPI
1164042412
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
Legal business name
HOMETOWN DIRECT PRIMARY CARE PLLC
Practice address
124 E Stewart St
Coats, NC 27521-8352
Phone
(919) 901-7344
Fax
(877) 807-8251
NPI assigned
Apr 16, 2020
Organization subpart
No

Authorized official

Name
Crystal B Rambeau, MD
Title
Owner
Phone
(919) 901-7344

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200708003652 NC Part B Supplier - Clinic/Group Practice 9638592686 Receives reassigned benefits from 1 practitioner
Practice locations: Coats, NC

National Provider Directory

Locations

124 E Stewart St
Coats, NC 27521
Phone (919) 901-7344

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Yes

Addresses

Primary practice location

124 E Stewart St
Coats, NC 27521-8352

Mailing address

3949 Chalybeate Springs Rd
Fuquay Varina, NC 27526-6207
Phone (919) 910-7344

Other providers in Coats, NC

All providers in Coats, NC · Primary Care Clinic/Center in North Carolina

Sources for this page

Verify at the official NPI Registry.