Provider Demographics
NPI:1326380940
Name:FAMILY MEDICAL CARE LLC
Entity Type:Organization
Organization Name:FAMILY MEDICAL CARE LLC
Other - Org Name:VILLAGE MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:704-867-2026
Mailing Address - Street 1:2545 W FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-1249
Mailing Address - Country:US
Mailing Address - Phone:704-867-2026
Mailing Address - Fax:704-867-2026
Practice Address - Street 1:2545 W FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-1249
Practice Address - Country:US
Practice Address - Phone:704-867-2026
Practice Address - Fax:704-867-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care