# WFUBMCCP PRIMARY CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTH CAROLINA BAPTIST HOSPITAL
- **Other names:** Wake Forest Baptist Healthcare Center - Davie
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1407007131
- **Legal business name:** NORTH CAROLINA BAPTIST HOSPITAL
- **Authorized official:** MR. MCLAIN WALLACE JR. (GENERAL COUNSEL)
- **Authorized official phone:** (336) 716-2817

## Contact information

- **Practice address:** 1188 YADKINVILLE RD, MOCKSVILLE, NC 27028-2037
- **Practice address phone:** (336) 751-8304
- **Practice address fax:** (336) 751-8402
- **Mailing address:** PO BOX 1209, MOCKSVILLE, NC 27028-1209
- **Mailing address phone:** (336) 751-8304
- **Mailing address fax:** (336) 751-8402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/30/2008
- **Last updated:** 09/30/2008