1376824607 NPI number — ASSOCIATED UROLOGISTS OF NORTH CAROLINA PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376824607 NPI number — ASSOCIATED UROLOGISTS OF NORTH CAROLINA PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATED UROLOGISTS OF NORTH CAROLINA PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376824607
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3821 ED DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27612-8038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-758-8677
Provider Business Mailing Address Fax Number:
919-758-8723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 TILGHMAN DR
Provider Second Line Business Practice Location Address:
SUITE 702
Provider Business Practice Location Address City Name:
DUNN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28334-5519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-892-1068
Provider Business Practice Location Address Fax Number:
910-892-4527
Provider Enumeration Date:
08/31/2011

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
TOMIKA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, REVENUE CYCLE MANAGEMENT
Authorized Official Telephone Number:
919-390-7400

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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