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NPI Code Detail

MEDICARE: LAKEVIEW URGENT CARE AND FAMILY CLINIC, INC.

MEDICARE: LAKEVIEW URGENT CARE AND FAMILY CLINIC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center
2261QX0100XOccupational Medicine Clinic/Center
3261QU0200XUrgent Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2012YEOTHERNCBCBS GRP NUMBER

General Provider Information

NPI Number : 1285687491
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKEVIEW URGENT CARE AND FAMILY CLINIC, INC.
Provider Business Mailing Address
First Line : 3622 N MAIN ST
Second Line :
City : HOPE MILLS
State : NC
Zip : 28348-1937
Country : US
Telephone Number : 910-423-7771
Fax Number : 910-423-4177
Provider Business Practice Location Address
First Line : 3622 N MAIN ST
Second Line :
City : HOPE MILLS
State : NC
Zip : 28348-1937
Country : US
Telephone Number : 910-423-7771
Fax Number : 910-423-4177
Authorized Official
Title or Position : CHIEF OPERATION OFFICER
Name : MRS. INGRID Y PAYNE
Credential : COO
Telephone Number : 910-323-1481
Provider Enumeration Date : 05/18/2006
Last Update Date : 07/19/2010

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Directions to “LAKEVIEW URGENT CARE AND FAMILY CLINIC, INC. ” Practice Location

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