Organization
CENTERS FOR ADVANCED UROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANIE MARIE COCHRAN (CREDENTIALING AGENT)
(336) 306-9755
Entity
Organization
Contact information
Practice address
1904 S MAIN ST STE 114, WAKE FOREST, NC 27587-5030
(919) 390-3978
Mailing address
1904 S MAIN ST STE 114, WAKE FOREST, NC 27587-5030
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
10/28/2025
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