Provider Demographics
NPI:1417441585
Name:MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA
Entity Type:Organization
Organization Name:MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-346-2273
Mailing Address - Street 1:1899 N MARINE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6555
Mailing Address - Country:US
Mailing Address - Phone:910-937-7200
Mailing Address - Fax:910-937-7061
Practice Address - Street 1:1899 N MARINE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6555
Practice Address - Country:US
Practice Address - Phone:910-937-7200
Practice Address - Fax:910-937-7061
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care