Provider Demographics
NPI:1437240280
Name:MCGREW CHIROPRACTIC CLINIC PA
Entity type:Organization
Organization Name:MCGREW CHIROPRACTIC CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:MCGREW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-873-3777
Mailing Address - Street 1:2238 SOUTH CHIPLEY FORD ROAD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-8706
Mailing Address - Country:US
Mailing Address - Phone:704-873-3777
Mailing Address - Fax:704-872-7534
Practice Address - Street 1:2238 SOUTH CHIPLEY FORD ROAD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-8706
Practice Address - Country:US
Practice Address - Phone:704-873-3777
Practice Address - Fax:704-872-7534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0806COtherBLUE CROSS BLUE SHIELD
NC890860CMedicaid
NC21962OtherPARTNERS
NC330716OtherAMERICAN CHIRO NETWORK
NC738494OtherMAMSI
NC21962OtherPARTNERS
NC330716OtherAMERICAN CHIRO NETWORK