WAKE TEEN MEDICAL SERVICES INC. NPI 1457319576

NPI Information

NPI: 1457319576
Provider Name: WAKE TEEN MEDICAL SERVICES INC.
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
505 OBERLIN RD
SUITE 204
RALEIGH, NC
ZIP 27605
Phone: (909) 828-0035
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WAKE TEEN MEDICAL SERVICES INC. is a health service clinic center in Raleigh, NC. WAKE TEEN MEDICAL SERVICES INC. NPI is 1457319576. The provider is registered as an organization entity type.

The provider's business location address is:

505 OBERLIN RD
SUITE 204
RALEIGH, NC
ZIP 27605-397
Phone: (909) 828-0035
Fax: (909) 828-0355

The provider's authorized official is Joyce Wood .
The authorized official title is President, Executive Director and has the following contact phone number (919) 828-0038.

The enumeration date for this NPI number is 5/1/2006 and was last updated on 8/22/2020.

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	261QH0100X	Clinic/Center	Health Service			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	02730	OTHER	NORTH CAROLINA	NC BCBS GROUP NUMBER
2	8902730	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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