Provider Demographics
NPI:1205230430
Name:MEDACCESS URGENT CARE, PLLC
Entity Type:Organization
Organization Name:MEDACCESS URGENT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:STALNAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:919-641-2046
Mailing Address - Street 1:PO BOX 1811
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-1811
Mailing Address - Country:US
Mailing Address - Phone:336-330-0400
Mailing Address - Fax:336-330-0031
Practice Address - Street 1:700 US 1 HWY
Practice Address - Street 2:STE 100
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596-7872
Practice Address - Country:US
Practice Address - Phone:919-562-2340
Practice Address - Fax:919-562-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care