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NPI 1588902498

NPI 1588902498 : URGENT CARES OF AMERICA NORTH CAROLINA INC : HARRISBURG, NC

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General NPI Number Information
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    NPI Number           |    1588902498
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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     |    01/28/2013
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Provider Practice Location Address
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    Address Line         |    4415 SCHOOL HOUSE CMNS 
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    City                 |    HARRISBURG
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    State                |    NC
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    Zip                  |    28075-7558
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    Country              |    US
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    Telephone            |    704-456-1218
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5626 OBERLIN DR 110
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92121-1705
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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 OPS
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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       |    103414
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    License Number State |    NC
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