Healthcare Provider Details

I. General information

NPI: 1568674216
Provider Name (Legal Business Name): FRIENDLY URGENT AND FAMILY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 COLLEGE RD
GREENSBORO NC
27410-5151
US

IV. Provider business mailing address

410 COLLEGE RD
GREENSBORO NC
27410-5151
US

V. Phone/Fax

Practice location:
  • Phone: 336-218-0994
  • Fax: 336-218-0997
Mailing address:
  • Phone: 336-218-0994
  • Fax: 336-218-0997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9700302
License Number StateNC

VIII. Authorized Official

Name: DR. ENRICO GUY JONES
Title or Position: OWNER DOCTOR
Credential: M.D
Phone: 336-218-0994