Provider Demographics
NPI:1780916866
Name:MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA
Entity type:Organization
Organization Name:MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-346-2273
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28541-0686
Mailing Address - Country:US
Mailing Address - Phone:910-346-2273
Mailing Address - Fax:910-346-1907
Practice Address - Street 1:308 DOLPHIN DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5266
Practice Address - Country:US
Practice Address - Phone:910-346-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-01
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty