Basic Information
| Provider Information | |||||||||
| NPI: | 1669705117 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HENDERSONVILLE URGENT CARE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 935 SHOTWELL RD | ||||||||
| Address2: | STE 108 | ||||||||
| City: | CLAYTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9195500821 | ||||||||
| FaxNumber: | 9195500735 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 SPARTANBURG HWY | ||||||||
| Address2: | STE 17 | ||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282331664 | ||||||||
| FaxNumber: | 8282331668 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2009 | ||||||||
| LastUpdateDate: | 09/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | REEVES | ||||||||
| AuthorizedOfficialFirstName: | NENA | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF BUSINESS DEVELOPMENT | ||||||||
| AuthorizedOfficialTelephone: | 9195500821 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | NC | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.