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NPI Code Detail

MEDICARE: MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC

MEDICARE: MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC
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
11041C0700XClinical Social Worker
2363A00000XPhysician Assistant
3363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1699748608
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC
Provider Business Mailing Address
First Line : PO BOX 772
Second Line : MINUTECLINIC CREDENTIALING-MC2295
City : WOONSOCKET
State : RI
Zip : 02895-0784
Country : US
Telephone Number : 866-389-2727
Fax Number : 401-406-3539
Provider Business Practice Location Address
First Line : 2340 SPRING FOREST RD
Second Line :
City : RALEIGH
State : NC
Zip : 27615-7528
Country : US
Telephone Number : 866-389-2727
Fax Number : 401-406-3539
Authorized Official
Title or Position : ADMINISTRATOR
Name : DEBORAH JEAN PINCINCE
Credential :
Telephone Number : 401-770-3813
Provider Enumeration Date : 02/09/2006
Last Update Date : 08/01/2023

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Directions to “MINUTECLINIC DIAGNOSTIC OF NORTH CAROLINA PC ” Practice Location

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