Healthcare Provider Details
I. General information
NPI: 1396847422
Provider Name (Legal Business Name): COMMUNITY URGENT CARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2006
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2469 WENDELL AVE
WENDELL NC
27591-6903
US
IV. Provider business mailing address
PO BOX 1985
WENDELL NC
27591-1985
US
V. Phone/Fax
- Phone: 919-365-9045
- Fax: 919-365-9046
- Phone: 919-365-9045
- Fax: 919-365-9046
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | NC |
VIII. Authorized Official
Name:
GINA
FARRINGER
Title or Position: OWNER
Credential: FNP
Phone: 919-365-9045