MEDAC HEALTH SERVICES PA (NPI# 1356345920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356345920 |
Entity Type | Organization |
Organization Name | MEDAC HEALTH SERVICES PA |
Practice Address |
4402 Shipyard Blvd Wilmington NC 28403 |
Mailing Address |
4402 Shipyard Blvd Wilmington NC 28403-6161 |
Practice Telephone | 9104521400 |
Practice Fax Number | 9103321072 |
Mailing Telephone | 9104521400 |
Mailing Fax Number | 9103321072 |
Enumeration Date | 2005-06-10 |
Last Update Date | 2019-10-28 |
Authorized Official Name | MICHAEL P. MOULTON, M.D. (PRESIDENT) |
Authorized Official Telephone | 9104521400 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | BCBS | 07651 | 01 |
NC | RAILROAD MEDICARE | CC2877 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346745098 | Medac Health Services Pa | General Practice | 5245 S College Rd, Wilmington, NC 28412-2209 | 2018-03-26 |
Street Address |
4402 SHIPYARD BLVD |
City | WILMINGTON |
State | NC |
Zip Code | 28403 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952305617 | Samuel Sherman Spicer | Family Medicine | 4402 Shipyard Blvd, Wilmington, NC 28403-6161 | 2005-06-10 |
1992165336 | Tara Rector | Physician Assistant | 4402 Shipyard Blvd, Wilmington, NC 28403-6161 | 2016-02-27 |
1659730091 | James Ryan O'reilly | Physician Assistant | 4402 Shipyard Blvd, Wilmington, NC 28403-6161 | 2016-02-13 |
1144687708 | Eric Dustin Morgan | Physician Assistant | 4402 Shipyard Blvd, Wilmington, NC 28403-6161 | 2016-01-26 |
1851781439 | Kristen Heffelfinger Wilson | Physician Assistant | 4402 Shipyard Blvd, Wilmington, NC 28403-6161 | 2015-02-03 |
1912341868 | Matthew Paul Geib | Emergency Medicine | 4402 Shipyard Blvd, Ecep II, Wilmington, NC 28403-6161 | 2013-04-23 |
1417273624 | Carrie Fales | Emergency Medicine | 4402 Shipyard Blvd, Wilmington, NC 28403-6161 | 2010-04-13 |
1235464017 | Joseph Dixon | Physician Assistant | 4402 Shipyard Blvd, Wilmington, NC 28403-6161 | 2009-10-12 |
1073742235 | James Arthur Helm | Physician Assistant | 4402 Shipyard Blvd, Wilmington, NC 28403-6161 | 2009-07-09 |
1750555629 | Joshua Ward Sawyer | Emergency Medicine | 4402 Shipyard Blvd, Wilmington, NC 28403-6161 | 2008-04-22 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
Find all providers in zip 28403 |
Taxonomy Code | 261QU0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Urgent Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992230833 | Greater Tomorrow Health, LLC | Clinic/Center | 2107 Rombach Ave, Wilmington, OH 45177-2099 | 2017-04-28 |
1629323266 | Fast Care Medical Aid Unit LLC | Clinic/Center | 3005 Governor Printz Blvd, Wilmington, DE 19802-2801 | 2012-07-19 |
1235443854 | Fairfax Medical P.a. | Clinic/Center | 2105 Concord Pike, Suite A, Wilmington, DE 19803-2906 | 2010-08-06 |
1619209475 | Premier Health Care LLC | Clinic/Center | 2845 Progress Way, Wilmington, OH 45177 | 2010-02-04 |
1164692844 | American Current Care of Massachusetts PC | Clinic/Center | 66b Concord Street, Wilmington, MA 01887-2179 | 2008-03-10 |
1891282109 | The Nemours Foundation | Clinic/Center | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2018-04-23 |
1750735189 | Beach Care PC | Clinic/Center | 6132 Carolina Beach Rd, Suite 8, Wilmington, NC 28412-2759 | 2016-04-22 |
1205262995 | Carolina Care - Urgent Care and Sports Medicine | Clinic/Center | 6832 Market St, Suite A, Wilmington, NC 28405-9723 | 2013-09-25 |
1124376496 | Angel Healthcare, LLC | Clinic/Center | 218 E Anaheim St, Wilmington, CA 90744-4516 | 2012-08-17 |
1972863611 | Wilmington Urgent Care and Family Clinic Inc | Clinic/Center | 714 N Avalon Blvd, Wilmington, CA 90744-5809 | 2012-05-28 |
Find all providers in WILMINGTON |
City | WILMINGTON |
Zip Code | 28403 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.