Provider Demographics
NPI:1316478431
Name:GUILFORD ADULT HEALTH, INC.
Entity type:Organization
Organization Name:GUILFORD ADULT HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUCK
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, MCHES
Authorized Official - Phone:336-895-4900
Mailing Address - Street 1:612 PASTEUR DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1149
Mailing Address - Country:US
Mailing Address - Phone:336-895-4900
Mailing Address - Fax:800-325-1945
Practice Address - Street 1:1103 W FRIENDLY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1863
Practice Address - Country:US
Practice Address - Phone:336-641-4533
Practice Address - Fax:336-641-5859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental