Provider Demographics
NPI:1457181323
Name:GOSHEN MEDICAL CENTER INCORPORATED
Entity type:Organization
Organization Name:GOSHEN MEDICAL CENTER INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOUNDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-267-2057
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:FAISON
Mailing Address - State:NC
Mailing Address - Zip Code:28341-0187
Mailing Address - Country:US
Mailing Address - Phone:910-267-2042
Mailing Address - Fax:855-996-9090
Practice Address - Street 1:EAST HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-7525
Practice Address - Country:US
Practice Address - Phone:910-719-3666
Practice Address - Fax:888-220-8461
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOSHEN MEDICAL CENTER INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-06
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)