DEACON MED PA NPI 1881998748

NPI Information

  • NPI: 1881998748
  • Provider Name: DEACON MED PA
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: OPTIMUS MEDICAL CENTER AT RANDLEMAN
  • Address: 702 S MAIN ST
    RANDLEMAN, NC
    ZIP 27317
  • Phone: (336) 545-1515

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NPI Details

DEACON MED PA is a primary care clinic center in Randleman, NC. DEACON MED PA NPI is 1881998748. The provider is registered as an organization entity type.
The provider Is Doing Business As Optimus Medical Center At Randleman.

The provider's business location address is:

702 S MAIN ST
RANDLEMAN, NC
ZIP 27317-102
Phone: (336) 545-1515
Fax: (336) 545-4505

The provider's authorized official is Jerome I Davis .
The authorized official title is Medical Director and has the following contact phone number (336) 545-1515.

The enumeration date for this NPI number is 1/6/2011 and was last updated on 1/6/2011.

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
1261QP2300XClinic/CenterPrimary CareNORTH CAROLINAYes

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: 11/21/2025

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