BOMRAY MEDICAL CLINIC NPI 1013974864

NPI Information

BOMRAY MEDICAL CLINIC is a primary care clinic center in Charlotte, NC. BOMRAY MEDICAL CLINIC NPI is 1013974864. The provider is registered as an organization entity type.
The provider Is Doing Business As Primecare Medical Center.

The provider's business location address is:

3627 BEATTIES FORD RD
CHARLOTTE, NC
ZIP 28216-249
Phone: (704) 335-0806
Fax: (704) 334-2073

The provider's authorized official is Jerri Olszewski .
The authorized official title is Billing Representative and has the following contact phone number (704) 335-0806.

The CLIA number assigned to this NPI record is 34D0940480 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 4/26/2006 and was last updated on 7/20/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.