Organization · Type 2 NPI

Black River Health Services Inc

Federally Qualified Health Center (FQHC) · Atkinson, NC

NPI number 1174511976 Active

Practice location

109 W Church St
Atkinson, NC 28421-9230

Call (910) 283-7783 Map

Fax (910) 283-7927

Mailing address

301 S Campbell St
Burgaw, NC 28425-5011

Specialties and licenses

Taxonomy	Code	License
Internal Medicine Physician	207R00000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed
Rural Health Clinic/Center	261QR1300X	None listed
Family Nurse Practitioner	363LF0000X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

William Fossett, FNP-CFamily Nurse Practitioner Atkinson, NC NPI 1851860183

NPI record

NPI: 1174511976
Entity type: Organization (Type 2)
Issued: Oct 6, 2005
Last updated: Dec 12, 2019
Status: Active

Other names

<unavail>
Black River Health Center · doing business as
Black River Health Center · doing business as

Authorized official

Lee Ann Amann
Administrator
(910) 259-6973

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174511976

Black River Health Services Inc's National Provider Identifier is 1174511976, issued on Oct 6, 2005. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Atkinson, NC. The record was last updated on Dec 12, 2019.