Healthcare Provider Details
I. General information
NPI: 1023076932
Provider Name (Legal Business Name): CHILDRENS ACUTE CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2006
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1638 OWEN DR PEDIATRIC EMERGENCY DEPT
FAYETTEVILLE NC
28304-3424
US
IV. Provider business mailing address
1333 N BUFFALO DR STE 290
LAS VEGAS NV
89128-3636
US
V. Phone/Fax
- Phone: 910-615-3182
- Fax: 910-615-3176
- Phone: 702-395-7095
- Fax: 702-395-3502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0204X |
| Taxonomy | Pediatric Emergency Medicine (Pediatrics) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
FRANK
R
GIOIA
Title or Position: PRESIDENT
Credential: MD
Phone: 702-395-7095