Online Payment

Pay Your Bill Online

Use the form below to provide payment information. Your Patient Number can be found at the top right corner of your bill.

Patient's Name(Required)

First Last

Patient Number(Required)

Enter the Invoice ID number on your bill

Payment Amount(Required)

Payer's Name (on credit card)(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

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2406 Century Place SE, Hickory, NC 28602 Phone: 828.324.9550 | Fax: 828.324.4154