Provider Demographics
NPI:1073550505
Name:MY URGENT CARE PC
Entity Type:Organization
Organization Name:MY URGENT CARE PC
Other - Org Name:URGENT MEDICAL CARE OF LAKE RIDGE P C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-494-2434
Mailing Address - Street 1:14527 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-2817
Mailing Address - Country:US
Mailing Address - Phone:703-494-6160
Mailing Address - Fax:703-434-3519
Practice Address - Street 1:14527 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-2817
Practice Address - Country:US
Practice Address - Phone:703-494-6160
Practice Address - Fax:703-434-3519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center