Basic Information
| Provider Information | |||||||||
| NPI: | 1821391491 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FASTMED URGENT CARE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 935 SHOTWELL RD | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | CLAYTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275205597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9195500821 | ||||||||
| FaxNumber: | 9195500735 | ||||||||
| Practice Location | |||||||||
| Address1: | 178 HIGHWAY 105 EXT | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | BOONE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286075254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282657146 | ||||||||
| FaxNumber: | 8282657150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2010 | ||||||||
| LastUpdateDate: | 08/22/2013 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | JASON | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO, EASTERN REGION | ||||||||
| AuthorizedOfficialTelephone: | 9195500821 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 208D00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.