Provider Demographics
NPI:1003408071
Name:PRIORITY ACCESS URGENT CARE LLC
Entity Type:Organization
Organization Name:PRIORITY ACCESS URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-446-0555
Mailing Address - Street 1:2912 JOHNSTON ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3246
Mailing Address - Country:US
Mailing Address - Phone:337-446-0555
Mailing Address - Fax:
Practice Address - Street 1:2912 JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3246
Practice Address - Country:US
Practice Address - Phone:337-446-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIORITY ACCESS URGENT CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty