Provider Demographics
NPI:1326003419
Name:MEDICORPCARE, INC
Entity Type:Organization
Organization Name:MEDICORPCARE, INC
Other - Org Name:ACER DEVELOPMENT CORPORATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:RECAREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-205-4828
Mailing Address - Street 1:PO BOX 2825
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28106-2825
Mailing Address - Country:US
Mailing Address - Phone:775-205-4828
Mailing Address - Fax:775-743-5983
Practice Address - Street 1:1817 WATLINGTON DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-0785
Practice Address - Country:US
Practice Address - Phone:775-205-4828
Practice Address - Fax:775-743-5983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health