Provider Demographics
NPI:1235366345
Name:URGENT CARE XPRESS, LLC
Entity Type:Organization
Organization Name:URGENT CARE XPRESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:TAWIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-434-7830
Mailing Address - Street 1:3316A SOUTH COBB DRIVE
Mailing Address - Street 2:STE: 187
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080
Mailing Address - Country:US
Mailing Address - Phone:770-434-7830
Mailing Address - Fax:770-434-7834
Practice Address - Street 1:3330 SOUTH COBB DRIVE
Practice Address - Street 2:STE: B
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080
Practice Address - Country:US
Practice Address - Phone:770-434-7830
Practice Address - Fax:770-434-7834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2009275261QM1300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care