Provider Demographics
NPI:1255906988
Name:MEDIQ URGENT CARE PC
Entity type:Organization
Organization Name:MEDIQ URGENT CARE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEEZAN
Authorized Official - Middle Name:
Authorized Official - Last Name:QAYUMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-738-1691
Mailing Address - Street 1:10102 S MAIN ST STE U
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-3183
Mailing Address - Country:US
Mailing Address - Phone:336-900-1441
Mailing Address - Fax:
Practice Address - Street 1:10102 S MAIN ST STE U
Practice Address - Street 2:
Practice Address - City:ARCHDALE
Practice Address - State:NC
Practice Address - Zip Code:27263-3183
Practice Address - Country:US
Practice Address - Phone:336-900-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDIQ URGENT CARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-25
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care