FASTMED URGENT CARE OF FUQUAY - NPI 1063757045 - Non-Pharmacy Dispensing Site in Fuquay Varina, NC

Q: What is Urgent Cares Of America North Carolina Inc's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

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About Fastmed Urgent Care Of Fuquay NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FASTMED URGENT CARE OF FUQUAY (NPI 1063757045) is a healthcare organization registered as a non-pharmacy dispensing site in Fuquay Varina, North Carolina and active in the NPI registry since December 2012. The organization holds a CLIA Waiver certificate valid through November 20, 2027 and lists Kenny Heine, Vp Ops, as its authorized official.

NPPES Registry Identity

NPI1063757045

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NameURGENT CARES OF AMERICA NORTH CAROLINA INC

Location Address1418 N MAIN STFuquay Varina, NC 27526-8901

Mailing Address9276 Scranton Rd, 100San Diego, CA 92121-7701

Phone(919) 552-1733

Organization SubpartYesParent: Medvantx, Inc.

Authorized OfficialKenny HeineVp Ops · (858) 964-1506

Enumeration DateDecember 3, 2012

Last NPPES UpdateMay 12, 2016

✔ NPI 1063757045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

License✔ Licensed in NC · 0010-03979

Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

1418 N MAIN ST, Fuquay Varina, NC 27526

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Other Names 1

Doing Business AsFastmed Urgent Care Of Fuquay

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D1019561

Fastmed · Fuquay Varina, NC

Active · expires Nov 20, 2027

CLIA Number34D1019561

Laboratory TypePhysician Office

Certificate Effective DateNovember 21, 2025

Certificate Expiration DateNovember 20, 2027

Laboratory DirectorThomas Brant

Laboratory Phone(919) 552-1733

Laboratory LocationFastmed1418 N Main St, Fuquay Varina, NC 27526

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRITTANY CAROTHERS PA

Physician Assistant