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IREDELL PHYSICIAN NETWORK LLC NPI 1053018648


NPI Information

NPI: 1053018648
Provider Name: IREDELL PHYSICIAN NETWORK, LLC

Doing Business As: IREDELL URGENT CARE STATESVILLE

Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 34D2278757

Address:
1540 E BROAD ST
STATESVILLE, NC
ZIP 28625
Phone: (704) 878-4542
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IREDELL PHYSICIAN NETWORK, LLC is an urgent care clinic center in Statesville, NC. IREDELL PHYSICIAN NETWORK, LLC NPI is 1053018648. The provider is registered as an organization entity type.
The provider Is Doing Business As Iredell Urgent Care Statesville.

The provider's business location address is:

1540 E BROAD ST
STATESVILLE, NC
ZIP 28625-302
Phone: (704) 878-4542

The provider's authorized official is Joanie M Cochran .
The authorized official title is Credentialing Agent and has the following contact phone number (336) 306-9755.

The CLIA number assigned to this NPI record is 34D2278757 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/14/2023 and was last updated on 2/21/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QU0200XClinic/CenterUrgent CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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