Provider Demographics
NPI:1194161380
Name:QUICKER CARE CLINIC PA
Entity type:Organization
Organization Name:QUICKER CARE CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATION OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:REID
Authorized Official - Last Name:SCYOC
Authorized Official - Suffix:
Authorized Official - Credentials:COO,PM-C,RMA,BAT
Authorized Official - Phone:910-330-2335
Mailing Address - Street 1:1224 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-2405
Mailing Address - Country:US
Mailing Address - Phone:252-447-7474
Mailing Address - Fax:252-447-1050
Practice Address - Street 1:1224 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-2405
Practice Address - Country:US
Practice Address - Phone:252-447-7474
Practice Address - Fax:252-447-1050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty