Healthcare Provider Details

I. General information

NPI: 1225075468
Provider Name (Legal Business Name): MEDI URGENT CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 CARTER PARK DR SUITE 3A
SENECA SC
29678-1152
US

IV. Provider business mailing address

111 CARTER PARK DR SUITE A
SENECA SC
29678-1152
US

V. Phone/Fax

Practice location:
  • Phone: 864-882-1420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAFDAR ALAM
Title or Position: MD
Credential:
Phone: 864-882-1420