Provider First Line Business Practice Location Address:
3000 NEW BERN AVE
Provider Second Line Business Practice Location Address:
WAKE MED HOSP CRITICAL HEALTH SYSTEMS OF NORTH CAROLINA
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27610-9400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-350-8820
Provider Business Practice Location Address Fax Number:
919-350-7385
Provider Enumeration Date:
10/24/2006