Healthcare Provider Details

I. General information

NPI: 1821268004
Provider Name (Legal Business Name): RAPIDCARE URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4622 40TH AVE S
FARGO ND
58104-4394
US

IV. Provider business mailing address

1517 32ND AVE S
FARGO ND
58103-5905
US

V. Phone/Fax

Practice location:
  • Phone: 701-232-6211
  • Fax: 701-364-9346
Mailing address:
  • Phone: 701-232-6211
  • Fax: 701-364-9346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7790
License Number StateND

VIII. Authorized Official

Name: RODNEY JOHN LEE
Title or Position: OWNER
Credential: MD
Phone: 701-232-6211