Provider Demographics
NPI:1881360899
Name:CAROLINA QUICKCARE FAMILY PRACTICE, PLLC
Entity type:Organization
Organization Name:CAROLINA QUICKCARE FAMILY PRACTICE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-813-9104
Mailing Address - Street 1:2265 NC HIGHWAY 24 27 E
Mailing Address - Street 2:
Mailing Address - City:BISCOE
Mailing Address - State:NC
Mailing Address - Zip Code:27209-9758
Mailing Address - Country:US
Mailing Address - Phone:919-828-1131
Mailing Address - Fax:910-876-8023
Practice Address - Street 1:2265 NC HIGHWAY 24 27 E
Practice Address - Street 2:
Practice Address - City:BISCOE
Practice Address - State:NC
Practice Address - Zip Code:27209-9758
Practice Address - Country:US
Practice Address - Phone:919-810-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINA QUICKCARE FAMILY PRACTICE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-19
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty