Provider Demographics
NPI:1164737235
Name:URGENCY ROOM, PC
Entity Type:Organization
Organization Name:URGENCY ROOM, PC
Other - Org Name:AFC URGENT CARE / FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-575-8528
Mailing Address - Street 1:503 PORPOISE DR
Mailing Address - Street 2:
Mailing Address - City:FRIPP ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29920-7217
Mailing Address - Country:US
Mailing Address - Phone:843-575-8528
Mailing Address - Fax:888-788-1304
Practice Address - Street 1:272 ROBERT SMALLS PKWY STE 310
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-3703
Practice Address - Country:US
Practice Address - Phone:843-575-8528
Practice Address - Fax:843-521-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP5647Medicaid
SCPTAN 9744Medicare UPIN