MEDICARE: FRIENDLY URGENT AND FAMILY CARE

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	207Q00000X	Family Medicine Physician	9700302	NC
2	261QU0200X	Urgent Care Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1568674216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDLY URGENT AND FAMILY CARE

Provider Business Mailing Address
First Line	:	410 COLLEGE RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-5151
Country	:	US
Telephone Number	:	336-218-0994
Fax Number	:	336-218-0997

Provider Business Practice Location Address
First Line	:	410 COLLEGE RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-5151
Country	:	US
Telephone Number	:	336-218-0994
Fax Number	:	336-218-0997

Authorized Official
Title or Position	:	OWNER DOCTOR
Name	:	DR. ENRICO GUY JONES
Credential	:	M.D
Telephone Number	:	336-218-0994

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	10/15/2013

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