OrganizationActive
Centers for Advanced Urology, LLC
NPI 1659947117 · Non-Pharmacy Dispensing Site · Wake Forest, NC
Provider details
- NPI number
- 1659947117
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Organization subpart
- No
- Authorized official
- Joanie Cochran, Credentialing Agent(336) 306-9755
Specialties & taxonomies
Suppliers
Practice location
1904 S Main St Ste 114
Wake Forest, NC 27587-5030
Phone: (919) 390-3978
Approximate (ZIP-level) locationGet directions
Mailing address
1904 S Main St Ste 114
Wake Forest, NC 27587-5030
Registry dates
- Enumerated
- 2021-06-03
- Last updated
- 2025-10-28
- Certified
- 2025-10-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.