MEDICARE: CARTERET URGENT CARE CENTER

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
1	207P00000X	Emergency Medicine Physician	NC28198	NC
2	207Q00000X	Family Medicine Physician	NC28198	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0140X	OTHER	NC	SNC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0140X	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1376689927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARTERET URGENT CARE CENTER

Provider Business Mailing Address
First Line	:	3104 ARENDELL ST
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-3202
Country	:	US
Telephone Number	:	252-247-0770
Fax Number	:	252-240-1384

Provider Business Practice Location Address
First Line	:	3104 ARENDELL ST
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-3202
Country	:	US
Telephone Number	:	252-247-0770
Fax Number	:	252-240-1384

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. PHILICIA LONG GRAY
Credential	:
Telephone Number	:	252-247-0770

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	09/11/2007

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Directions to “CARTERET URGENT CARE CENTER ” Practice Location

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