Healthcare Provider Details
I. General information
NPI: 1922037845
Provider Name (Legal Business Name): CABARRUS URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/02/2006
Last Update Date: 04/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
888 CHURCH ST N
CONCORD NC
28025-4350
US
IV. Provider business mailing address
PO BOX 601351
CHARLOTTE NC
28260-1351
US
V. Phone/Fax
- Phone: 704-786-6122
- Fax: 704-784-9102
- Phone: 704-786-6122
- Fax: 704-784-9102
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
L
WIENS
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 704-355-0648