Provider Demographics
NPI:1346327707
Name:SIGNET HEALTHCARE, PC
Entity Type:Organization
Organization Name:SIGNET HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-642-0300
Mailing Address - Street 1:PO BOX 1527
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-1527
Mailing Address - Country:US
Mailing Address - Phone:910-642-0300
Mailing Address - Fax:910-640-3327
Practice Address - Street 1:15 HILL PLZ STE A
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4950
Practice Address - Country:US
Practice Address - Phone:910-642-0300
Practice Address - Fax:910-640-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36494261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC44960OtherMEDCOST
NC0245HOtherEMPIRE BCBS
NC0245HOtherOPTION BLUECROSS BLUESHIELD
NCCK5068OtherRAILROAD MEDICARE
SCNPB005OtherSOUTH CAROLINA MEDICAID
NC0245HOtherBLUECROSS BLUESHIELD
NC0245HOtherFEDERAL BLUECROSS BLUESHIELD
4140662NCOtherAETNA
NC7067596009OtherCIGNA
NC0245HOtherBLUECROSS BLUESHIELD STATE
NC110069099OtherPALMETTA GBA
NC216449OtherCOVENTRY HEALTHCARE PLAN
NC89013UYMedicaid
NC110069099OtherPALMETTA GBA
NC=========NCOtherTRICARE
NC110069099OtherPALMETTA GBA
NCCK5068OtherRAILROAD MEDICARE