Provider Demographics
NPI:1679665145
Name:MONTGOMERY COUNTY PRIMARY CARE CORP
Entity Type:Organization
Organization Name:MONTGOMERY COUNTY PRIMARY CARE CORP
Other - Org Name:ASKARY OBSTETRICS AND GYNECOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-5181
Mailing Address - Street 1:921 S LONG DR STE 104
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-4874
Mailing Address - Country:US
Mailing Address - Phone:910-417-3445
Mailing Address - Fax:910-417-3449
Practice Address - Street 1:921 S LONG DR STE 104
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4874
Practice Address - Country:US
Practice Address - Phone:910-417-3445
Practice Address - Fax:910-417-3449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18925207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0177AOtherBCBS
NC89014VRMedicaid
NC2322119Medicare PIN