1558550442 NPI number — RAPIDCARE URGENT CARE PLLC

Table of content: (NPI 1558550442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558550442 NPI number — RAPIDCARE URGENT CARE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAPIDCARE URGENT CARE PLLC
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:
1558550442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1517 32ND AVE S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARGO
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58103-5905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-232-6211
Provider Business Mailing Address Fax Number:
701-364-9346

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
720 MAIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOORHEAD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56560-2752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-232-6221
Provider Business Practice Location Address Fax Number:
218-359-0096
Provider Enumeration Date:
10/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LEWIS
Authorized Official First Name:
ABIGAIL
Authorized Official Middle Name:
V
Authorized Official Title or Position:
CLINIC MANAGER
Authorized Official Telephone Number:
701-232-6211

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  41391 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 510066600 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com