Provider Demographics
NPI:1366488280
Name:METROPOLITAN COMMUNITY HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:METROPOLITAN COMMUNITY HEALTH SERVICES, INC
Other - Org Name:AGAPE COMMUNITY HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-644-7003
Mailing Address - Street 1:PO BOX 1886
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-1886
Mailing Address - Country:US
Mailing Address - Phone:252-940-0602
Mailing Address - Fax:252-940-0605
Practice Address - Street 1:120 W MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4906
Practice Address - Country:US
Practice Address - Phone:252-940-0602
Practice Address - Fax:252-940-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344591AMedicaid
NC890179GOtherNORTH CAROLINA ACCESS
NC0179GOtherBCBS
NC2321587Medicare PIN
NC890179GOtherNORTH CAROLINA ACCESS