Provider Demographics
NPI:1770885139
Name:ROSEWOOD IMMEDIATE CARE PLLC
Entity type:Organization
Organization Name:ROSEWOOD IMMEDIATE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-735-5757
Mailing Address - Street 1:172 US HIGHWAY 581 SOUTH
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-9404
Mailing Address - Country:US
Mailing Address - Phone:919-735-5757
Mailing Address - Fax:
Practice Address - Street 1:166 B US HWY 581 SOUTH
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-9557
Practice Address - Country:US
Practice Address - Phone:919-288-5228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20113261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care