Provider Demographics
NPI:1558550442
Name:RAPIDCARE URGENT CARE PLLC
Entity Type:Organization
Organization Name:RAPIDCARE URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:V
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-232-6211
Mailing Address - Street 1:1517 32ND AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5905
Mailing Address - Country:US
Mailing Address - Phone:701-232-6211
Mailing Address - Fax:701-364-9346
Practice Address - Street 1:720 MAIN AVE
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2752
Practice Address - Country:US
Practice Address - Phone:701-232-6221
Practice Address - Fax:218-359-0096
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAPIDCARE URGENT CAREPLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-17
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN41391207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN510066600Medicaid
010000341Medicare PIN
MN510066600Medicaid