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NPI 1295073112

NPI 1295073112 : URGENT CARES OF AMERICA NORTH CAROLINA INC : MONROE, NC

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General NPI Number Information
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    NPI Number           |    1295073112
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    Entity Type          |    Organization 
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    Legal Business Name  |    URGENT CARES OF AMERICA NORTH CAROLINA INC 
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Dates
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    Enumeration Date     |    01/28/2013
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    Last Update Date     |    12/30/2015
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Provider Practice Location Address
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    Address Line         |    2242 W ROOSEVELT BLVD 
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    City                 |    MONROE
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    State                |    NC
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    Zip                  |    28110-3070
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    Country              |    US
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    Telephone            |    704-220-1904
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9276 SCRANTON RD SUITE 100
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92121-7701
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    VP OF OPERATIONS
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    Name                 |     KENNY  HEINE 
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    Credential           |    
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    Telephone            |    858-964-1506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332900000X
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    Taxonomy Name        |    Non-Pharmacy Dispensing Site
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    License Number       |    0010-05344
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    License Number State |    NC
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