Provider Demographics
NPI:1982662854
Name:RALEIGH URGENT CARE CENTER, PA
Entity Type:Organization
Organization Name:RALEIGH URGENT CARE CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:GREENE
Authorized Official - Last Name:MASK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-231-3131
Mailing Address - Street 1:2600 NEW BERN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1821
Mailing Address - Country:US
Mailing Address - Phone:919-231-3131
Mailing Address - Fax:919-231-3981
Practice Address - Street 1:2600 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1821
Practice Address - Country:US
Practice Address - Phone:919-231-3131
Practice Address - Fax:919-231-3981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26453207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty