Provider Demographics
NPI:1003227893
Name:GOSHEN MEDICAL CENTER, INCORPORATED
Entity Type:Organization
Organization Name:GOSHEN MEDICAL CENTER, INCORPORATED
Other - Org Name:GOSHEN MEDICAL CENTER - NEW BERN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:TEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-267-2057
Mailing Address - Street 1:4114 DR M L KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2233
Mailing Address - Country:US
Mailing Address - Phone:252-772-9995
Mailing Address - Fax:910-267-8931
Practice Address - Street 1:4007 M L KING JR BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2243
Practice Address - Country:US
Practice Address - Phone:252-772-9995
Practice Address - Fax:910-267-8931
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOSHEN MEDICAL CENTER, INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-14
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)