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General NPI Number Information
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NPI Number | 1225383243
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Entity Type | Organization
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Legal Business Name | MID-ATLANTIC QUICKCARE PLLC
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 5261 CARROLLTON PIKE SUITE C
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City | WOODLAWN
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State | VA
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Zip | 24381-3668
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Country | US
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Telephone | 276-238-0911
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Fax | 276-238-0912
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Provider Business Mailing Address
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Address Line | 5261 CARROLLTON PIKE SUITE C
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City | WOODLAWN
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State | VA
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Zip | 24381
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Country | US
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Telephone | 276-238-0911
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Fax | 276-238-0912
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. CARRIE BURNETTE
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Credential | RN,BSN
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Telephone | 276-238-0911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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