Provider Demographics
NPI:1194393769
Name:FAITH PRIMARY CARE PLUS
Entity Type:Organization
Organization Name:FAITH PRIMARY CARE PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NGONDA'YEBENIT
Authorized Official - Middle Name:NZELLE
Authorized Official - Last Name:NGO MAYEBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-430-9120
Mailing Address - Street 1:329 SANFORD DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-2575
Mailing Address - Country:US
Mailing Address - Phone:828-430-9120
Mailing Address - Fax:828-430-9122
Practice Address - Street 1:329 SANFORD DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-2575
Practice Address - Country:US
Practice Address - Phone:828-430-9120
Practice Address - Fax:828-430-9122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty