Provider Demographics
NPI:1235189473
Name:FRYECARE URGENT CARE, PLLC
Entity Type:Organization
Organization Name:FRYECARE URGENT CARE, PLLC
Other - Org Name:FRYECARE URGENT CARE - HUDSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF OUTPATIENT SERVICES, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:BURTNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-893-2153
Mailing Address - Street 1:PO BOX 281510
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1510
Mailing Address - Country:US
Mailing Address - Phone:828-728-2080
Mailing Address - Fax:828-728-5056
Practice Address - Street 1:3060 HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NC
Practice Address - Zip Code:28638-2659
Practice Address - Country:US
Practice Address - Phone:828-728-2080
Practice Address - Fax:828-728-5056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01766OtherBCBS
NC5903433Medicaid
2348037Medicare PIN