Provider Demographics
NPI:1992840003
Name:ANSON REGIONAL MEDICAL SERVICES, INC
Entity type:Organization
Organization Name:ANSON REGIONAL MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MPA,RHIT
Authorized Official - Phone:704-694-6700
Mailing Address - Street 1:PO BOX 192
Mailing Address - Street 2:203 SALISBURY STREET
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-0192
Mailing Address - Country:US
Mailing Address - Phone:704-694-6700
Mailing Address - Fax:704-694-5454
Practice Address - Street 1:203 SALISBURY ST
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2155
Practice Address - Country:US
Practice Address - Phone:704-694-6700
Practice Address - Fax:704-695-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344553Medicaid
NC344553Medicaid