Queen City Primary And Urgent Care | |
5820 E W T Harris Blvd Ste B Charlotte NC 28215-3542 | |
(704) 548-7962 | |
(704) 613-3431 |
Full Name | Queen City Primary And Urgent Care |
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Speciality | Clinic/Center |
Location | 5820 E W T Harris Blvd Ste B, Charlotte, North Carolina |
Authorized Official Name and Position | Mohammad Kasaji (PRESIDENT) |
Authorized Official Contact | 9145899963 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Queen City Primary And Urgent Care 5820 E W T Harris Blvd Ste B Charlotte NC 28215-3542 Ph: () - | Queen City Primary And Urgent Care 5820 E W T Harris Blvd Ste B Charlotte NC 28215-3542 Ph: (704) 548-7962 |
NPI Number | 1679263552 |
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Provider Enumeration Date | 05/12/2023 |
Last Update Date | 08/13/2024 |
Medicare PECOS PAC ID | 2466815600 |
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Medicare Enrollment ID | O20230905004186 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679263552 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Provider Name | Mohammad Khalil Kasaji |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194987677 PECOS PAC ID: 9739313602 Enrollment ID: I20190327000225 |
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