Provider Demographics
NPI:1164859138
Name:NORTH JACKSON URGENT CARE LLC
Entity Type:Organization
Organization Name:NORTH JACKSON URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMD CHIEF MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-218-3818
Mailing Address - Street 1:P.O. BOX 1050
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768
Mailing Address - Country:US
Mailing Address - Phone:256-437-1020
Mailing Address - Fax:256-437-1047
Practice Address - Street 1:42950 U.S. HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:AL
Practice Address - Zip Code:35772
Practice Address - Country:US
Practice Address - Phone:256-437-1020
Practice Address - Fax:256-437-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care