Organization
BOMRAY MEDICAL CLINIC
Active
Other names
PrimeCare Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JERRI OLSZEWSKI (BILLING REPRESENTATIVE)
(704) 335-0806
Entity
Organization
Contact information
Practice address
3627 BEATTIES FORD RD, CHARLOTTE, NC 28216-3249
(704) 335-0806
(704) 334-2073
Mailing address
3627 BEATTIES FORD RD, CHARLOTTE, NC 28216-3249
(704) 335-0806
(704) 334-2073
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QS1000X
Student Health Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890271W
—
NC
Enumeration date
04/26/2006
Last updated
07/20/2010
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