GOSHEN MEDICAL CENTER INCORPORATED (NPI# 1164695375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164695375 |
| Entity Type | Organization |
| Organization Name | GOSHEN MEDICAL CENTER INCORPORATED |
| Other Organization Name | GOSHEN MEDICAL CENTER BOLTON |
| Practice Address |
213 9th St Bolton NC 28423-8410 |
| Mailing Address |
Po Box 187 Faison NC 28341-0187 |
| Practice Telephone | 9106558300 |
| Mailing Telephone | 9102670421 |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2015-02-18 |
| Authorized Official Name | REBECCA M BROWN (CREDENTIALING) |
| Authorized Official Telephone | 9102678252 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Goshen Medical Center Bolton | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376084251 | Goshen Medical Center Incorporated | Clinic/Center | 138 Lyman Rd, Beulaville, NC 28518-7614 | 2017-03-13 |
| 1184165078 | Goshen Medical Center Incorporated | Clinic/Center | 158 Lanefield Rd, Warsaw, NC 28398-8717 | 2017-03-13 |
| 1497296370 | Goshen Medical Center Incorporated | Clinic/Center | 4266 S Nc Highway 11, Wallace, NC 28466-6114 | 2017-03-13 |
| 1295113371 | Goshen Medical Center Incorporated | Clinic/Center | 270 N Us 701 Bypass, Tabor City, NC 28463-2705 | 2015-05-11 |
| 1326443870 | Goshen Medical Center Incorporated | Clinic/Center | 104 Adair Dr Ste C, Goldsboro, NC 27530-4516 | 2014-10-27 |
| 1194128991 | Goshen Medical Center Incorporated | Clinic/Center | 104 Adair Dr # A, Goldsboro, NC 27530-4516 | 2014-10-07 |
| 1538407036 | Goshen Medical Center Incorporated | Clinic/Center | 5 Whiteville Towne Ctr, Whiteville, NC 28472-4929 | 2013-01-18 |
| 1669797700 | Goshen Medical Center Incorporated | Clinic/Center | 1200 Hargett St, Jacksonville, NC 28540-5933 | 2010-04-01 |
| 1912170002 | Goshen Medical Center Incorporated | Clinic/Center | 105 South Lisbon Avenue, Garland, NC 28441-0398 | 2008-04-09 |
| 1083739429 | Goshen Medical Center Incorporated | Clinic/Center | 200 W. Ash St., Ste#202, Goldsboro, NC 27530-3679 | 2007-03-21 |
| Street Address |
213 9TH ST |
| City | BOLTON |
| State | NC |
| Zip Code | 28423-8410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699883769 | Bolton Health & Wellness Center | Family Medicine | 213 9th St, Bolton, NC 28423-8410 | 2006-08-28 |
| 1720147986 | Kimberly Anne Major | Physician Assistant | 213 9th St, Bolton, NC 28423-8410 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538530969 | Aci Support Specialists, Inc | Case Management | 95 Mcduffie Avenue, Bolton, NC 28423 | 2015-10-12 |
| 1295970358 | Kelly Barnes Laham | Nurse Practitioner | 213 9th Street, Bolton, NC 28423 | 2008-12-03 |
| 1891920039 | Access Nc, LLC | Community/Behavioral Health | 15354 Sam Potts Hwy, Bolton, NC 28423-8408 | 2009-05-18 |
| 1902146921 | Ronnette Smith | Custodial Care Facility | 492 Spearman Rd, Bolton, NC 28423-8622 | 2013-02-28 |
| 1740520758 | Ronnette Rochelle Ashley | Custodial Care Facility | 492 Spearman Rd, Bolton, NC 28423-8622 | 2013-02-28 |
| 1588009336 | Elite Care of Nc, LLC | Ambulance | 740 Jacobs Rd, Bolton, NC 28423-8924 | 2013-05-07 |
| 1497702070 | Ameratech of North Carolina Inc | Ambulance | 784 Jacobs Rd, Bolton, NC 28423-8924 | 2006-05-28 |
| 1215984075 | Buckhead Volunteer Fire Department and Rescue Squad Inc | Ambulance | 6810 Old Lake Rd, Bolton, NC 28423-8958 | 2006-05-27 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1851909444 | Gaston Family Health Services, Inc. | Clinic/Center | 302 28th Ave Ne, Hickory, NC 28601-1116 | 2020-07-20 |
| 1750999496 | Gaston Family Health Services, Inc. | Clinic/Center | 180 War Eagle Dr, Mocksville, NC 27028-6151 | 2020-07-20 |
| 1518575265 | Gaston Family Health Services, Inc. | Clinic/Center | 4675 Oxford School Rd, Claremont, NC 28610-9468 | 2020-07-20 |
| 1124636873 | Gaston Family Health Services, Inc. | Clinic/Center | 451 Catawba Valley Blvd, Hickory, NC 28602-9631 | 2020-07-20 |
| 1093323099 | Gaston Family Health Services, Inc. | Clinic/Center | 5040 E Bandys Xrd, Catawba, NC 28609-8075 | 2020-07-16 |
| 1366088957 | Gaston Family Health Services, Inc. | Clinic/Center | 497 Farmington Rd, Mocksville, NC 27028-7639 | 2019-11-19 |
| 1285270868 | Gaston Family Health Services, Inc. | Clinic/Center | 160 Martin Luther King Junior Rd, Mocksville, NC 27028 | 2019-11-19 |
| 1306481957 | Gaston Family Health Services, Inc. | Clinic/Center | 3407 Plateau Rd, Newton, NC 28658-8809 | 2019-11-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.