MEDICARE: RAPIDCARE URGENT 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	7790	ND

General Provider Information

NPI Number	:	1821268004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAPIDCARE URGENT CARE

Provider Business Mailing Address
First Line	:	1517 32ND AVE S
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58103-5905
Country	:	US
Telephone Number	:	701-232-6211
Fax Number	:	701-364-9346

Provider Business Practice Location Address
First Line	:	4622 40TH AVE S
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58104-4394
Country	:	US
Telephone Number	:	701-232-6211
Fax Number	:	701-364-9346

Authorized Official
Title or Position	:	OWNER
Name	:	RODNEY JOHN LEE
Credential	:	MD
Telephone Number	:	701-232-6211

Provider Enumeration Date	:	03/04/2008
Last Update Date	:	03/06/2008

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