Organization
WAKEMED SPECIALISTS GROUP, LLC
Active
Other names
WakeMed Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA JAYOUSSI (EXECUTIVE DIRECTOR OF FINANCE)
(919) 350-6089
Entity
Organization
Contact information
Practice address
811 US 70 HWY W, GARNER, NC 27529-2541
(919) 235-6565
(919) 235-6596
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0554
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386209633
—
NC
Enumeration date
11/18/2019
Last updated
11/18/2019
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