Organization
WAKE SPECIALTY PHYSICIANS LLC
Active
Other names
WakeMed MyCare 365 Primary & Urgent Care Wake Forest
Organization subpart
No
Provider details
NPI number
Authorized official
SHONDRA LYNN BRINK (VP, WPP OPERATIONS)
(919) 350-6045
Entity
Organization
Contact information
Practice address
2001 S MAIN ST STE 200, WAKE FOREST, NC 27587-1652
(919) 350-0365
(919) 235-1307
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0552
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346852407
—
NC
Enumeration date
01/25/2021
Last updated
01/28/2021
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