Organization Name: | BEACHCARE URGENT MEDICAL CARE CENTER OF HAVELOCK |
NPI Number: | 1083600720 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM GRAHAM EVANS (CLINICAL DIRECTOR/OWNER) |
Mailing Address: | 1224 E Main St Havelock |
State: | NC US |
Postal Code: | 285322405 |
Phone Number: | 2524477474 |
Fax Number: | 2524471050 |
NPI Enumeration Date: | 09/27/2005 |
NPI Last Update Date: | 11/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 39759 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |