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General NPI Number Information
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NPI Number | 1356345920
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Entity Type | Organization
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Legal Business Name | MEDAC HEALTH SERVICES, PA
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 4402 SHIPYARD BLVD
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City | WILMINGTON
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State | NC
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Zip | 28403
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Country | US
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Telephone | 910-791-0075
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Fax | 910-791-5359
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Provider Business Mailing Address
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Address Line | 216 CENTERVIEW DR
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City | BRENTWOOD
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State | TN
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Zip | 37027-3226
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Country | US
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Telephone | 910-791-0075
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Fax | 910-791-5359
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Authorized Official
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Title or Position | CEO
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Name | DAVID MALONEY
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Credential |
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Telephone | 616-656-2750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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