Provider Demographics
NPI:1891161956
Name:HENDERSON COUNTY FREE MEDICAL CLINIC
Entity Type:Organization
Organization Name:HENDERSON COUNTY FREE MEDICAL CLINIC
Other - Org Name:THE FREE CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-697-8422
Mailing Address - Street 1:841 CASE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-6503
Mailing Address - Country:US
Mailing Address - Phone:828-697-8422
Mailing Address - Fax:828-697-8453
Practice Address - Street 1:841 CASE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-6503
Practice Address - Country:US
Practice Address - Phone:828-697-8422
Practice Address - Fax:828-697-8453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCSL003007251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable