Provider Demographics
NPI:1568674216
Name:FRIENDLY URGENT AND FAMILY CARE
Entity Type:Organization
Organization Name:FRIENDLY URGENT AND FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ENRICO
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-218-0994
Mailing Address - Street 1:410 COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-5151
Mailing Address - Country:US
Mailing Address - Phone:336-218-0994
Mailing Address - Fax:336-218-0997
Practice Address - Street 1:410 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-5151
Practice Address - Country:US
Practice Address - Phone:336-218-0994
Practice Address - Fax:336-218-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700302207Q00000X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89127M8Medicaid
NC5670350001Medicare NSC
NC2280565BMedicare PIN