GOSHEN MEDICAL CENTER INCORPORATED (NPI# 1912022369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912022369 |
| Entity Type | Organization |
| Organization Name | GOSHEN MEDICAL CENTER INCORPORATED |
| Other Organization Name | GOSHEN MEDICAL CENTER WALLACE |
| Practice Address |
110 Eastwood Drive Wallace NC 28466-9236 |
| Mailing Address |
Po Box 187 Faison NC 28341-0187 |
| Practice Telephone | 9102852330 |
| Practice Fax Number | 9102853060 |
| Mailing Telephone | 9102670421 |
| Mailing Fax Number | 9102670441 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2012-02-06 |
| Authorized Official Name | REBA W. FUTRELL (EXECUTIVE ASSISTANT/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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 344011A | 05 |
| Other Name | Type Code |
|---|---|
| Goshen Medical Center Wallace | 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 |
110 EASTWOOD DRIVE |
| City | WALLACE |
| State | NC |
| Zip Code | 28466-9236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225121494 | Claudia Compton Smith | Nurse Practitioner | 110 Eastwood Drive, Wallace, NC 28466-9236 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326518630 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 114 N Northwood St, Wallace, NC 28466 | 2018-11-29 |
| 1659891232 | Tonia Gray | Registered Nurse | 407 Fremont Street, Burgaw, NC 28466 | 2017-06-23 |
| 1164968889 | Angela Boney | Pharmacist | 5625 S Nc Hwy 41, Wallace, NC 28466 | 2017-01-19 |
| 1790111961 | Realo Discount Drug Stores of Enc, Inc | Pharmacy | 5655 S Nc 41 Hwy, Wallace, NC 28466 | 2013-09-19 |
| 1699938993 | The Lawsons House | Clinic/Center | 116 West Main St, Wallace, NC 28466 | 2008-07-07 |
| 1184842098 | Continuum Care Corporation | Assisted Living Facility | 1052 Ne Railroad St., Wallace, NC 28466 | 2007-04-23 |
| 1467677229 | Pigfords Physical Therapy Assoc Inc | Physical Therapist | 112 E Medical Village Dr, Wallace, NC 28466 | 2007-04-16 |
| 1598875379 | Wilson Family Pharmacies Inc | Pharmacy | 116 East Main St, Wallace, NC 28466 | 2006-08-30 |
| 1659317394 | Axon Darren Sholar | Dentist | 522 S Norwood St, Wallace, NC 28466 | 2006-06-21 |
| 1083121396 | Kelsey Lynn Vallee | Pharmacist | 5717 S Nc 41 Hwy, Wallace, NC 28466 | 2018-01-08 |
| Find all providers in zip 28466 | ||||
| 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 |
|---|---|---|---|---|
| 1497296370 | Goshen Medical Center Incorporated | Clinic/Center | 4266 S Nc Highway 11, Wallace, NC 28466-6114 | 2017-03-13 |
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| 1518575265 | Gaston Family Health Services, Inc. | Clinic/Center | 4675 Oxford School Rd, Claremont, NC 28610-9468 | 2020-07-20 |
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| 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 |
| Find all providers with the same taxonomy | ||||
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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.