Provider Demographics
NPI:1336693787
Name:CVS MINUTE CLINIC
Entity Type:Organization
Organization Name:CVS MINUTE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:336-766-0324
Mailing Address - Street 1:5041 TEAL CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-6813
Mailing Address - Country:US
Mailing Address - Phone:336-407-9267
Mailing Address - Fax:
Practice Address - Street 1:2770 LEWISVILLE CLEMMONS RD
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8716
Practice Address - Country:US
Practice Address - Phone:336-766-0324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-14
Last Update Date:2016-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363LF0000X261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center