Dba Cabarrus Mercy Clinic
LBN: Providence Medical Clinic, Inc.
Dba Cabarrus Mercy Clinic is an health care organization with primary practice located at 271 Ne Executive Park Drive , Concord NC 28025. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty.
Providence Medical Clinic, Inc. can be contacted via phone (704) 721-4232, or through Adekanmbi, Adebola K. via phone (704) 721-4232.
Contact Information
Primary practice address
271 Ne Executive Park Drive
Concord NC 28025
Phone: (704) 721-4232
Fax: (704) 721-4240
Website:
Authorized official contact:
Name: Adekanmbi, Adebola K. Doctor of Medicine (MD)
Phone: (704) 721-4232
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 9900744 | North Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | NC9900744 | North Carolina |
Profile Details
| NPI number | 1336155951 |
|---|---|
| LBN Legal business name | Providence Medical Clinic, Inc. |
| DBA Doing business as | Dba Cabarrus Mercy Clinic |
| Authorized official | Adekanmbi, Adebola K. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 1st, 2006 |
| Last updated | Feb 1st, 2010 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336155951 | NPPES |
| North Carolina | MEDICAID | 89012PN | |
| North Carolina | MEDICAID | 891226E |
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