Provider Demographics
NPI:1952986762
Name:AMERICAN FAMILY CARE GREENSBORO
Entity type:Organization
Organization Name:AMERICAN FAMILY CARE GREENSBORO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:W
Authorized Official - Last Name:FEATHERSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-944-1359
Mailing Address - Street 1:107 GAINSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9273
Mailing Address - Country:US
Mailing Address - Phone:336-944-1359
Mailing Address - Fax:
Practice Address - Street 1:107 GAINSWOOD DR
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9273
Practice Address - Country:US
Practice Address - Phone:336-944-1359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care