Provider Demographics
NPI:1952938326
Name:SCENIC URGENT CARE
Entity type:Organization
Organization Name:SCENIC URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-352-4900
Mailing Address - Street 1:1118 BLEVINS STORE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-9086
Mailing Address - Country:US
Mailing Address - Phone:336-401-0304
Mailing Address - Fax:
Practice Address - Street 1:113 SCENIC OUTLET LN
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-9976
Practice Address - Country:US
Practice Address - Phone:336-352-4900
Practice Address - Fax:336-352-4901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care