Healthcare Provider Details

I. General information

NPI: 1932432481
Provider Name (Legal Business Name): BOONE UC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 HIGHWAY 105 EXT SUITE 101
BOONE NC
28607
US

IV. Provider business mailing address

11373 US HIGHWAY 70 WEST
CLAYTON NC
27520
US

V. Phone/Fax

Practice location:
  • Phone: 919-550-0821
  • Fax:
Mailing address:
  • Phone: 919-550-0821
  • Fax:

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: MR. JASON A WILLIAMS
Title or Position: OWNER
Credential:
Phone: 919-550-0821