Provider Demographics
NPI:1972833838
Name:PROMPTCARE CLINIC, PLLC
Entity type:Organization
Organization Name:PROMPTCARE CLINIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICIAN ASISTANT
Authorized Official - Phone:910-286-3598
Mailing Address - Street 1:201 LIVERMORE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-7322
Mailing Address - Country:US
Mailing Address - Phone:910-286-3598
Mailing Address - Fax:
Practice Address - Street 1:201 LIVERMORE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-7322
Practice Address - Country:US
Practice Address - Phone:910-286-3598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE YROGERG MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-28
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty