Provider Demographics
NPI:1225383243
Name:MID-ATLANTIC QUICKCARE PLLC
Entity Type:Organization
Organization Name:MID-ATLANTIC QUICKCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:276-238-0911
Mailing Address - Street 1:5261 CARROLLTON PIKE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WOODLAWN
Mailing Address - State:VA
Mailing Address - Zip Code:24381
Mailing Address - Country:US
Mailing Address - Phone:276-238-0911
Mailing Address - Fax:276-238-0912
Practice Address - Street 1:5261 CARROLLTON PIKE
Practice Address - Street 2:SUITE C
Practice Address - City:WOODLAWN
Practice Address - State:VA
Practice Address - Zip Code:24381-3668
Practice Address - Country:US
Practice Address - Phone:276-238-0911
Practice Address - Fax:276-238-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center