National Provider Identifier Database

BOMRAY MEDICAL CLINIC
Primary Care


Contact Information

BOMRAY MEDICAL CLINIC
3627 BEATTIES FORD RD
CHARLOTTE, NC28216-3249
Phone: 704-335-0806
Fax: 704-334-2073
Website:
Specialty Taxonomy Code
* Primary Care 261QP2300X
Clinic/Center 261Q00000X
Health Service 261QH0100X
Student Health 261QS1000X
Urgent Care 261QU0200X

* Indicates primary specialty

NPI Profile & details for BOMRAY MEDICAL CLINIC

NPI Number 1013974864
Legal business name
LBN
BOMRAY MEDICAL CLINIC
Authorized official JERRI OLSZEWSKI - (BILLING REPRESENTATIVE)
Entity Organization
Organization subpart No
Enumeration date 04/26/2006
Last updated 07/20/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • NC Medicaid: 890271W

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for BOMRAY MEDICAL CLINIC

There are currently no reviews for BOMRAY MEDICAL CLINIC


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