Healthcare Provider Details
I. General information
NPI: 1194152744
Provider Name (Legal Business Name): URGENT CARES OF AMERICA NORTH CAROLINA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2013
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 SUNSET AVE
ROCKY MOUNT NC
27804-2523
US
IV. Provider business mailing address
9276 SCRANTON RD SUITE 100
SAN DIEGO CA
92121-7701
US
V. Phone/Fax
- Phone: 919-550-0821
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | 2011-00283 |
| License Number State | NC |
VIII. Authorized Official
Name:
KENNY
HEINE
Title or Position: VP OF OPERATIONS
Credential:
Phone: 858-964-1506