Organization · NPI-2

Avner Asset LLC

Clinic/Center, Military Outpatient Operational (Transportable) Component · Jacksonville, NC

NPI number1174295364
StatusActive
Last updated in NPPESOct 12, 2021

Details

NPI
1174295364
Entity type
Organization (NPI-2)
Legal business name
Avner Asset LLC
Organization subpart
No
Enumeration date
Oct 5, 2021
Certification date
Oct 12, 2021
Last updated
Oct 12, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM1102X Clinic/Center, Military Outpatient Operational (Transportable) Component––Yes

Practice location

425 Myrtlewood Cir
Jacksonville, NC 28546-7411

Phone 760-805-6602

Mailing address

425 Myrtlewood Cir
Jacksonville, NC 28546-7411

Phone 760-805-6602

Authorized official

John Doreus
General Manager
7608056602

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