FREEDOM MEDICAL CLINIC & URGENT CARE PA NPI 1255450235

NPI Information

NPI: 1255450235
Provider Name: FREEDOM MEDICAL CLINIC & URGENT CARE PA
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 34D1038272

Address:
2905 FREEDOM DRIVE
CHARLOTTE, NC
ZIP 28208
Phone: (704) 394-3033
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FREEDOM MEDICAL CLINIC & URGENT CARE PA is a primary care clinic center in Charlotte, NC. FREEDOM MEDICAL CLINIC & URGENT CARE PA NPI is 1255450235. The provider is registered as an organization entity type.

The provider's business location address is:

2905 FREEDOM DRIVE
CHARLOTTE, NC
ZIP 28208-857
Phone: (704) 394-3033
Fax: (704) 394-3395

The provider's authorized official is Ndofunsu Badika .
The authorized official title is Owner and has the following contact phone number (704) 394-3033.

The CLIA number assigned to this NPI record is 34D1038272 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 3/28/2007 and was last updated on 7/14/2014.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I51372	MEDICARE UPIN	NORTH CAROLINA
2	2346988	OTHER	NORTH CAROLINA	MEDIARE PTAN
3	5901934	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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