Organization
MED 360 URGENT CARE NORTHPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAROUK A RAQUIB MD (OWNER/ MD)
(205) 326-3875
Entity
Organization
Contact information
Practice address
3250 MCFARLAND BLVD, NORTHPORT, AL 35476-3135
(205) 487-4535
(205) 487-8875
Mailing address
3250 MCFARLAND BLVD STE A, NORTHPORT, AL 35476-3135
(205) 632-3875
(205) 462-3056
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477511194
NPI
AL
05
—
315872
—
AL
05
—
322964
—
AL
01
—
512-92816
BCBS
AL
Enumeration date
10/05/2022
Last updated
10/08/2024
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