Basic Information
| Provider Information | |||||||||
| NPI: | 1801215330 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCPC-8, LLC | ||||||||
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| OtherOrganizationName: | FIRSTHEALTH CONVENIENT CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 896208 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282893298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107151010 | ||||||||
| FaxNumber: | 9107151026 | ||||||||
| Practice Location | |||||||||
| Address1: | 7473-C HWY 22 | ||||||||
| Address2: | |||||||||
| City: | WHISPERING PINES | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102155100 | ||||||||
| FaxNumber: | 9102155114 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2014 | ||||||||
| LastUpdateDate: | 08/18/2021 | ||||||||
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| AuthorizedOfficialLastName: | FOSTER | ||||||||
| AuthorizedOfficialFirstName: | MICKEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9107151913 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.