Healthcare Provider Details

I. General information

NPI: 1326003419
Provider Name (Legal Business Name): MEDICORPCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 WATLINGTON DR
CHARLOTTE NC
28270-0785
US

IV. Provider business mailing address

PO BOX 2825
MATTHEWS NC
28106-2825
US

V. Phone/Fax

Practice location:
  • Phone: 775-205-4828
  • Fax: 775-743-5983
Mailing address:
  • Phone: 775-205-4828
  • Fax: 775-743-5983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RAUL A RECAREY
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 775-205-4828