Provider Demographics
NPI:1023571528
Name:HEALTH CHOICE URGENT CARE, LLC
Entity Type:Organization
Organization Name:HEALTH CHOICE URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-4139
Mailing Address - Street 1:3711 S MO PAC EXPY STE 400
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-8013
Mailing Address - Country:US
Mailing Address - Phone:470-655-2364
Mailing Address - Fax:470-407-2660
Practice Address - Street 1:2745 LOGANVILLE HWY
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-3005
Practice Address - Country:US
Practice Address - Phone:470-655-2364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care