Healthcare Provider Details

I. General information

NPI: 1518293208
Provider Name (Legal Business Name): BOSS URGENT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2009
Last Update Date: 10/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 N RALEIGH ST
ANGIER NC
27501-9121
US

IV. Provider business mailing address

PO BOX 579
FUQUAY VARINA NC
27526-0579
US

V. Phone/Fax

Practice location:
  • Phone: 919-567-3139
  • Fax: 919-586-0933
Mailing address:
  • Phone: 919-567-3139
  • Fax: 919-586-0933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRENDA BUCK
Title or Position: OFFICE MANAGER
Credential:
Phone: 910-577-1555