Provider Demographics
NPI:1194779256
Name:URGENT CARE CENTERS OF CAROLINA, INC.
Entity type:Organization
Organization Name:URGENT CARE CENTERS OF CAROLINA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRATALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-479-9888
Mailing Address - Street 1:PO BOX 281774
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1774
Mailing Address - Country:US
Mailing Address - Phone:919-479-9888
Mailing Address - Fax:919-479-9882
Practice Address - Street 1:3901 N ROXBORO ST
Practice Address - Street 2:SUITE 701
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2181
Practice Address - Country:US
Practice Address - Phone:919-479-9888
Practice Address - Fax:919-479-9882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCDA3125OtherMEDICARE RR
NCDA3125OtherMEDICARE RR