Provider Demographics
NPI:1790365526
Name:UNITED HEALTH CENTERS
Entity Type:Organization
Organization Name:UNITED HEALTH CENTERS
Other - Org Name:UHC PHARMACY PETERS CREEK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:743-219-1143
Mailing Address - Street 1:2101 PETERS CREEK PKWY STE 16-19
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-3726
Mailing Address - Country:US
Mailing Address - Phone:336-293-8728
Mailing Address - Fax:336-999-7657
Practice Address - Street 1:2101 PETERS CREEK PKWY STE 16-19
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-3726
Practice Address - Country:US
Practice Address - Phone:336-293-8728
Practice Address - Fax:336-999-7657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy