Healthcare Provider Details

I. General information

NPI: 1124086814
Provider Name (Legal Business Name): CHILDRENS ACUTE CARE OF FAYETTEVILLE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 OWEN DR - PICU
FAYETTEVILLE NC
28304-3424
US

IV. Provider business mailing address

1333 N BUFFALO DR SUITE 290
LAS VEGAS NV
89128-3636
US

V. Phone/Fax

Practice location:
  • Phone: 910-615-3182
  • Fax: 910-615-3176
Mailing address:
  • Phone: 702-395-7095
  • Fax: 702-395-3502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANK GIOIA
Title or Position: PRESIDENT
Credential: MD
Phone: 702-395-7095