GOSHEN MEDICAL CENTER, INC. (NPI# 1679718316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679718316 |
| Entity Type | Organization |
| Organization Name | GOSHEN MEDICAL CENTER, INC. |
| Other Organization Name | GOSHEN MEDICAL CENTER-FREMONT |
| Practice Address |
109 S Sycamore St Fremont NC 27830-8710 |
| Practice Telephone | 9192424382 |
| Practice Fax Number | 9192424526 |
| Mailing Telephone | 9192424382 |
| Mailing Fax Number | 9192424526 |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2010-03-26 |
| Authorized Official Name | MRS. REBA W. FUTRELL (EXECUTIVE ASSISTANT/CREDENTIALING) |
| Authorized Official Telephone | 9102671942 |
| Is Organization Subpart | Y |
| Parent Organization Name | GOSHEN MEDICAL CENTER INC. |
| 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-Fremont | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265767172 | Goshen Medical Center, Inc. | Clinic/Center | 212 Duplin St, Kenansville, NC 28349 | 2009-10-09 |
| 1215366216 | Goshen Medical Center, Inc. | Clinic/Center | 3613 Cape Center Dr, Fayetteville, NC 28304-4457 | 2013-11-11 |
| 1477878874 | Goshen Medical Center, Inc. | Clinic/Center | 908 N Us Highway 421, Clinton, NC 28328-0410 | 2010-03-30 |
| Street Address |
109 S SYCAMORE ST |
| City | FREMONT |
| State | NC |
| Zip Code | 27830-8710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992804587 | Joseph Ray Warren Jr. | Physician Assistant | 109 S Sycamore St, Fremont, NC 27830-8710 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881724342 | Fremont Rest Center | Assisted Living Facility | 300 South Street, Fremont, NC 27830 | 2007-03-06 |
| 1275676561 | B & J Rest Villa | Assisted Living Facility | 305 South Vance Street, Fremont, NC 27830 | 2007-02-15 |
| 1407887862 | Jesse A Blackman, Md, Pa | Family Medicine | 109 S. Sycamore Street, Fremont, NC 27830 | 2006-07-05 |
| 1356484612 | B & J Rest Villa | Assisted Living Facility | 305 South Vance Street, Fremont, NC 27830 | 2007-02-15 |
| 1376757252 | House of Jabez LLC | Community Based Residential Treatment Facility, Mental Illness | 203 Dock Street, Fremont, NC 27830-0662 | 2007-05-09 |
| 1598384257 | Jessica Lynn Polk | Registered Nurse | 302 S Dock St, Fremont, NC 27830-2783 | 2020-04-13 |
| 1508243098 | Don Sin Dmd II Pa | Dentist | 102 S Sycamore St, Fremont, NC 27830-8709 | 2015-05-04 |
| 1174744270 | Calvin Scott Fuller | Dentist | 102 S. Sycamore St., 102 S. Sycamore St., Fremont, NC 27830-8709 | 2007-05-02 |
| 1093800328 | April Delyn Holland | Speech-Language Pathologist | 2092 Nc Highway 222 W, Fremont, NC 27830-9029 | 2006-10-03 |
| 1235471350 | Always Compassionate Family Care Home | Custodial Care Facility | 2907 Nc Highway 581 N, Fremont, NC 27830-9086 | 2013-03-27 |
| Find all providers in zip 27830 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245719129 | Bay Area Community Health | Clinic/Center | 40924 Fremont Blvd, Fremont, CA 94538-4375 | 2018-08-10 |
| 1497021109 | Bay Area Community Health | Clinic/Center | 3607 Main St Ste B, Fremont, CA 94538-4390 | 2012-03-27 |
| 1851515019 | Tri-city Health Center | Clinic/Center | 39184 State St, Fremont, CA 94538-1436 | 2007-04-12 |
| 1184791998 | Bay Area Community Health | Clinic/Center | 1999 Mowry Avenue, Fremont, CA 94538-1436 | 2006-11-29 |
| 1033296272 | Bay Area Community Health | Clinic/Center | 2299 Mowry Ave Ste 3b, Fremont, CA 94538-1621 | 2006-11-01 |
| 1780683573 | Community and Rural Health Services | Clinic/Center | 2221 Hayes Ave, Fremont, OH 43420-2632 | 2005-07-14 |
| 1457967267 | Bay Area Community Health | Clinic/Center | 1860 Mowry Ave Ste 400, Fremont, CA 94538-1730 | 2020-09-17 |
| 1780054379 | Bay Area Community Health | Clinic/Center | 40910 Fremont Blvd, Fremont, CA 94538-4375 | 2015-09-25 |
| 1902287261 | Good Neighbor Community Health Center | Clinic/Center | 2740 N Clarkson St, Fremont, NE 68025-7716 | 2015-06-12 |
| 1568840387 | Bay Area Community Health | Clinic/Center | 3607 Main St, Suite 3b, Fremont, CA 94538-4390 | 2015-05-13 |
| Find all providers in FREMONT | ||||
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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.